You treat a 27-year-old infertile patient with bromocriptine. What should be the diagnosis?: (A) Hyperpituitarism, (B) Hypopituitarism, (C) Polycystic ovarian disease (PCOD), (D) Hyperprolactinemia
Answer is D. ANS. DClinical manifestations of hyperprolactinemiaWomenMen* Galactorrhea 30-80%* Galactorrhea <30%* Menstrual irregularity* Impotence* Infertility Other manifestations* Visual field abnormalities* Headaches* Extraocular muscle weakness* Anterior pituitary malfunctionHypogonadism in both women and men by suppressing gonadotropin-releasing hormone (GnRh) secretion and pulsatility, resulting in low level of LH and FSH.Medical therapeutic options for the management of hyperprolactinemia* Dopamine agonists are currently the first therapeutic option* Dopamine agonists have proven efficacy in reducing prolactin levels, restoring ovulation in premenopausal women and restoring gonadal function in men* Bromocriptine has been used the longest* Cabergoline has greater affinity and selectivity for pituitary dopamine D2 receptor and longer duration of action.