Prolactin levels in functional hypothalamic amenorrhea: a retrospective case-control study

Purpose Functional hypothalamic amenorrhea (FHA) is due to hypothalamic dysregulation. Literature lacks data about prolactin in FHA women, although both prolactin levels and FHA are associated with stress. Moreover, polycystic ovarian morphology is common in FHA and there is an association between FHA and polycystic ovary syndrome. Thus, the aim of this study was to assess prolactin levels in FHA patients and controls with a special focus on factors influencing prolactin levels, that could be considered as sensors of the hypothalamic-pituitary dysregulation.Methods In a retrospective cohort study, 140 women with clearly defined FHA were compared to 70 healthy, normally ovulating women matched for age. The main outcome parameter was prolactin. Factors associated with prolactin levels > 12 mu g/L were tested using a multivariable binary logistic regression model.Results The median prolactin level was 11.5 mu g/L (interquartile range, IQR 7.5-14.4), which was similar to the control group (median 10.7, IQR 8.3-14.5; p = 0.065). Only two women had hyperprolactinemia (prolactin > 25 mu g/L; 1.4%). In a multivariable binary logistic regression model eating disorder (odds ratio, OR 0.206; p = 0.040), excessive exercise (OR 0.280; p = 0.031) and TSH (OR 1.923; p = 0.020) were significantly associated with prolactin levels > 12 mu g/L.Conclusion Women with FHA have similar prolactin levels to healthy age-matched individuals. Eating disorders and excessive exercise where associated with prolactin levels < 12 mu g/L, in contrast to TSH.

Automated summary

The aim of this study was to assess prolactin levels in FHA patients and controls and factors influencing prolactin levels. The results showed that women with FHA have similar prolactin levels to healthy age-matched individuals. Eating disorders and excessive exercise were associated with prolactin levels < 12 μg/L, while TSH was associated with prolactin levels > 12 μg/L.