Amenorrhea galactorrhea and pituitary tumors: postpill and non-postpill. (Abstract only)

191 patients with secondary amenorrhea were studied for a period of up to 5 years. In 69 patients amenorrhea followed the discontinuation of oral contraceptives (PPA) while in the remaining 122 the amenorrhea was not pill-related (NPPA). By utilizing the administration of progesterone in oil and the measurement of gonadotropins the patients were classified as having polycystic ovarian disease hypothalamic-pituitary dysfunction hypothalamic-pituitary failure or premature ovarian failure. Galactorrhea was present in 23% with NPPA of whom 95% had elevated serum prolactin (PRL) levels. Of those with PPA 49% had galactorrhea and 86% of these had increased PRL levels. Although only 7 patients had an abnormal sella turcica when initially evaluated follow-up revealed changes consistent with pituitary tumors in 16 (13%) of the patients with NPPA and in 18 (26%) of those with PPA. All but two of these had galactorrhea. The primary difference between patients with postpill and non-postpill amenorrhea was the significantly higher incidence of galactorrhea (P < 0.001) and pituitary tumors (P < 0.001) in those with PPA.(FULL TEXT)