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Bone Density in Amenorrheic Women with and without Hyperprolactinemia^*

Departments of Internal Medicine and Orthopedics (R.M.) and the Clinical Research Center University of Iowa, Iowa City, IA 52242

Address all correspondence and requests for reprints to: Janet A. Schlechte, M.D., Clinical Research Center, University of Iowa Hospital, Iowa City, Iowa 52242.

To determine whether decreased bone density in patients with PRL-secreting pituitary tumors is specifically related to hyperprolactinemia or is a consequence of disordered pituitary-gonadal function common to all amenorrheic states, we measured the bone mineral content of the radius by photon absorptiometry in normal subjects, in women with amenorrhea and normal serum PRL levels, and in women with PRL-secreting pituitary tumors. The women did not differ significantly in mean age, height, weight, or serum calcium, phosphorous, gonadotropin, testosterone, vitamin D, or PTH concentrations, and all had normal renal and thyroid function.

The bone mineral content in women with amenorrhea and normal serum PRL levels (0.91 ± 0.02 g/cm) was not significantly different from that in control subjects (0.88 ± 0.01 g/cm). Patients with PRL-secreting tumors studied 2–5 yr after transsphenoidal surgery had significantly diminished bone mineral content whether they were cured (0.82 ± 0.02 g/cm) or had persistent amenorrhea and hyperprolactinemia (0.81 ± 0.02 g/cm). Serum estradiol concentrations did not differ significantly in the four groups, and there was no correlation between estradiol concentration and bone mineral content or between PRL concentration and bone mineral content in the amenorrheic women.

The presence of decreased bone mineral content in hyperprolactinemic patients suggests that PRL may have a direct effect on bone and may be another indication for early treatment of PRL-secreting pituitary tumors. (J Clin Endocrinol Metab 56: 1120, 1983)

^* Presented in part at the 64th Annual Meeting of The Endocrine Society, San Francisco, CA, June 1982. This work was supported by Grants RR-59 and HD-13136, from the NIH.

Received October 4, 1982.

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