Circulating nitric oxide levels in galactorrheic, hyperprolactinemic, amenorrheic women.

OBJECTIVE

To test the hypothesis that nitric oxide production is decreased in hyperprolactinemic, amenorrheic patients with estrogen (E) deficiency, augmenting the possible risk of cardiovascular disorders.

SETTING

Cairo University Hospitals.

DESIGN

Prospective, case-controlled study.

PATIENT(S): Twenty-five galactorrheic, hyperprolactinemic patients with amenorrhea of more than 6 months and with low serum E2, as well as 30 healthy, fertile women (controls) matched for age and body mass index.

INTERVENTION(S): Bromocriptine was administered orally to hyperprolactinemic patients, and blood samples were collected before and 6 weeks after treatment.

MAIN OUTCOME MEASURE(S): Total nitric oxide production was determined photometrically using Greiss reagent after preliminary conversion of nitrate to nitrite by nitrate reductase.

RESULT(S): Serum E2 and nitric oxide levels in hyperprolactinemic, amenorrheic patients (62.5 +/- 3.2 [SE] pg/mL [229 +/- 11.7 pmol/L] and 18.4 +/- 2.5 mumol/L, respectively) were significantly lower than E2 (114 +/- 6.4 pg/ml, [418 +/- 23.5 pmol/L]) and nitric oxide (41.2 +/- 4.1 mumol/L) levels observed in normal women during the follicular phase. The decrease of nitric oxide was associated with elevation of blood pressure. Treatment of hyperprolactinemia with bromocriptine restored normal values of serum nitric oxide and E2, and normal blood pressure.

CONCLUSION(S): Hyperprolactinemia with E deficiency exhibits a significant decrease in nitric oxide production, and this decrease may subject the patient to certain cardiovascular disorders and disturbed ovarian function.