Prolactinoma and adrenal androgens.

Theories about the relationship between hyperprolactinemia and hyperandrogenism are conflicting. Several reports assert that prolactin affects the delta 5 and delta 4 pathways through its effect on the activity of 3beta-hydroxysteroid dehydrogenase (3beta-OHSD). We measured delta 5 and delta 4 steroids, prolactin and cortisol in 18 amenorrheic, hyperprolactinemic women before and after resection of prolactinomas. Similar determinations of delta 5: delta 4 steroids were made in a control group of five women. The ratios of individual delta 5: delta 4 steroids were also analyzed. Our results support a modification of delta 5, delta 4 pathways through an effect on the rate-limiting enzyme 3 beta-OHSD. In hyperprolactinemic women the differences between the preoperative and postoperative steroid levels were significant. Further, since the androgens decreased irrespective of the prolactin following surgery, there probably is a factor other than ACTH and prolactin modulating the adrenal androgens.