Клинико-гормональные аспекты у женщин репродуктивного возраста с пролактиномами

Abstract. Introduction. Prolactinoma is the most common pituitary adenoma, constituting 40-66% of cases in epidemiological studies. Its prevalence ranges from 25 to 63 per 100,000, with incidence rates of 2.1 to 5.4 cases per 100,000 annually. The increasing detection of prolactinomas is attributed to advances in imaging techniques, such as computer tomography / magnetic resonance tomography, and to the improved laboratory techniques, such as Enzyme Linked Immunosorbent Assay or Immunoradiometric assay, enabling earlier diagnosis. Regardless of tumor size, reproductive dysfunction—ranging from reduced libido through infertility — is a common symptom of the condition. The aim of this study is to evaluate the clinical-hormonal profile of women of reproductive age with prolactinomas and to analyze the relationship between prolactin levels, clinical manifestations of the disease, and reproductive function disorders. Material and Methods. The study involved 185 women aged 17 to 37 with prolactinomas, divided into two groups based on tumor size: Microadenomas and macroadenomas. The methods included clinical (BMI, blood calcium, vitamin D3, general blood test), hormonal (Prolactin, Follicle-Stimulating Hormone, Luteinizing Hormone, progesterone, estradiol, testosterone, Thyroid-Stimulating Hormone, free T4, inhibin A/B, activin, anti-Mullerian hormone), instrumental (ultrasound with folliculometry), and neuroimaging (neuro-ophthalmological, computer tomography / magnetic resonance tomography) techniques, alongside with statistical analysis. Results and Discussion. The study of 185 women with prolactinomas revealed that 61.6% were diagnosed during pregnancy, with microadenomas being more common. Patients experienced reproductive issues, including infertility and menstrual irregularities, alongside with hormonal imbalances, such as elevated prolactin and reduced Follicle-Stimulating Hormone and Luteinizing Hormone. Early detection and tailored treatment are crucial for managing these complications. Conclusions. Prolactinomas in women of reproductive age are associated with significant reproductive and hormonal disturbances. Early diagnosis and personalized treatment are essential to manage symptoms, including infertility and menstrual irregularities, and to improve patients’ outcomes. Keywords: clinical-hormonal profile, women, reproductive age, prolactinoma.