Prolactin level correction in restoration of menstrual cycle in obese women

Authors

DOI:

https://doi.org/10.18370/2309-4117.2021.62.53-58

Keywords:

obesity, metabolic syndrome, prolactin, menstrual disorders, Vitex Agnus Castus, Cyclodynon

Abstract

Obesity is a common problem among women of reproductive age. There are data from clinical and experimental studies indicating the role of hyperprolactinemia in the development of metabolic syndrome, as well as the metabolic benefits of treating hyperprolactinemia.
Research objective: to evaluate the clinical efficacy of Vitex Agnus Castus standardized extract on hormonal and metabolic status in women with menstrual cycle disorders and obesity.
Materials and methods. 60 women aged 19 to 35 years with obesity and menstrual cycle disorders with laboratory-confirmed insulin resistance and prolactin near the upper limit of the reference values or was slight increase were examined. All the patients were given recommendations for lifestyle modification. 30 of them, who formed the main group, received Cyclodynon. 30 patients of the control group were not prescribed Cyclodynon therapy.
Results. At the end of the treatment, the menstrual cycle was normalized in 93.3% patients of the main group, and in 66.3% patients of the control group (p < 0.05). Ovulation signs were detected in 86.67% women of the main group and only in 30.0% women of the control group (p < 0.05). The mean prolactin value and the HOMA index were significantly lower in the main group; prolactin level did not exceed the physiological values in 86.67% women in the main group after 6 months, and in 40.0% of the control group, p < 0.05. There was a decrease in body mass index and waist/hip circumference ratio in patients of the studied groups; the dynamics was slightly higher in the main group but did not differ significantly.
Conclusions. Cyclodynon is effective for the treatment of menstrual cycle disorders and metabolic disorders in women with obesity and metabolic syndrome. Good tolerability, absence of side effects, and sufficient efficacy of Cyclodynon allow it to be recommended as the drug of choice in patients with prolactin levels near the upper limit of the reference values or a slight increase of it and in patients with intolerance to synthetic dopamine agonists.

Author Biographies

T.F. Tatarchuk, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”; State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv

MD, professor, corresponding member of the NAMS of Ukraine, deputy director for research work, head of the Endocrine Gynecology Department;
Chief researcher, Department of Reproductive Health

N.V. Kosei, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”; SSI “Center for Innovative Medical Technologies of the NAS of Ukraine", Kyiv

MD, professor, chief researcher, Endocrine Gynecology Department;
Head of the Department of Reproductive Health

S.I. Reheda, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”; SSI “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv

PhD, senior researcher, Endocrine Gynecology Department;
Head of the Gynecology Department

M.I. Hlamazda, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”, Kyiv

Graduate student

I.M. Shakalo, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”, Kyiv

PhD, researcher, Endocrine Gynecology Department

References

  1. Dağ, Z.Ö., Dilbaz., B. “Impact of obesity on infertility in women.” J Turk Ger Gynecol Assoc 16.2 (2015): 1.
  2. Wang, T., et al. “Circulating prolactin associates with diabetes and impaired glucose regulation.” Diabetes Care 36.7 (2013): 1974–80.
  3. dos Santos Silva, C.M., et al. “BMI and metabolic profile in patients with prolactinoma before and after treatment with dopamine agonists.” Obesity (Silver Spring) 19 (2011): 800–5.
  4. Pereira-Lima, J., et al. “Hyperprolactinemia and body weight: prevalence of obesity and overweight in patients with hyperprolactinemia.” Res J Endocrin Metab (2013): 1–2. DOI: 10.7243/2053-3640-1-2
  5. Andersen, M., Glintborg, D. “Metabolic Syndrome in Hyperprolactinemia.” Front Horm Res 49 (2018): 29–47. DOI: 10.1159/000486000
  6. Grattan, D.R. “60 years of neuroendocrinology: the hypothalamo-prolactin axis.” J Endocrinol 2 (2015): T101–22.
  7. Bernabeu, I., Casanueva, F.F. “Metabolic syndrome associated with hyperprolactinemia: a new indication for dopamine agonist treatment?” Endocrine 44.2 (2013): 273–4. DOI: 10.1007/s12020-013-9914-1
  8. Tronko, M.D., Antypkin, Y.H, Kaminskyi, V.V., et al. “National Consensus on the Management of Patients with Hyperprolactinemia (2016).” Reproductive Endocrinology 4.30 (2016): 8–17. DOI: 10.18370/2309-4117.2016.30.8-18
  9. Arif, A.F. “Non Hormonal Management of Menstrual Cylce Irregularities.” J Gynecol Women’s Health 11.4 (2018): 555818. DOI: 10.19080/JGWH.2018.11.555818
  10. Alberti, K., Eckel, R.H., Grundy, S.M., et al. “Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.” Circulation 120.16 (2009): 1640–5. DOI: 10.1161/CIRCULATIONAHA.109.192644
  11. Centers for Disease Control and Prevention. “US Medical eligibility criteria for contraceptive use, 2010.” MMWR Recomm Rep 59.4 (2010): 1–86.
  12. Webster, D.E., He, Y., Chen, S.N., et al. “Opioidergic mechanisms underlying the actions of Vitex agnus-castus L.” Biochem Pharmacol 81.1 (2011): 170–7. DOI: 10.1016/j.bcp.2010.09.013
  13. Haerifar, N., et al. “The Effect of Vitex Agnus Castus Extract on the Blood Level of Prolactin, Sex Hormones Levels, and the Histological Effects on the Endometrial Tissue in Hyperprolactinemic Women.” Crescent J Med Biol Sci 7 (2020): 545–50.
  14. Huang, P.L. “A comprehensive definition for metabolic syndrome.” Dis Model Mech 2.5–6 (2009): 231–7. DOI: 10.1242/dmm.001180
  15. Budnyak, M.A., Burdyukova, E.A., Gurevich, K.G. Healthy lifestyle and disease prevention. Ed. N.D. Yushchuk, I.V. Maev, K.G. Gurevich. Moscow. Pero (2012): 659.
  16. Majumdar, A., Mangal, N.S. “Hyperprolactinemia.” J Hum Reprod Sci 6 (2013): 168–75.
  17. Lemini, M., Ruiz-Herrera, X., Ledesma-Colunga, M.G., et al. “Prolactin anterior pituitary expression and circulating levels are reduced in obese and diabetic rats: role of TGF-beta and TNF-alpha.” Am J Physiol Regul Integr Comp Physiol 308 (2015): R792–9.
  18. Pala, N.A., Laway, B.A., Misgar, R.A., et al. “Metabolic abnormalities in patients with prolactinoma: response to treatment with cabergoline.” Diabetol Metab Syndr 7.99 (2015). DOI: 10.1186/s13098-015-0094-4
  19. Ciresi, A., Amato, M.C., Guarnotta, V., et al. “Higher doses of cabergoline further improve metabolic parameters in patients with prolactinoma regardless of the degree of reduction in prolactin levels.” Clin Endocrinol 79 (2013): 845–52.
  20. Balbach, L., Wallaschofski, H., Völzke, H., et al. “Serum prolactin concentrations as risk factor of metabolic syndrome or type 2 diabetes?” BMC Endocr Disord 13 (2013): 12.
  21. Grimstad, F., Le, M., Zganjar, A., et al. “An Evaluation of Reported Follicle-stimulating Hormone, Luteinizing Hormone, Estradiol, and Prolactin Reference Ranges in the United States.” Urology 120 (2018): 114–9.
  22. Albu, A., Florea, S., Fica, S. “Is prolactin the missing link in adipose tissue dysfunction of polycystic ovary syndrome patients?” Endocrine 51 (2016): 163–73.
  23. Glintborg, D., Altinok, M., Mumm, H., et al. “Prolactin is associated with metabolic risk and cortisol in 1007 women with polycystic ovary syndrome.” Hum Reprod 29 (2014): 1773–9.
  24. Carré, N., Binart, N. “Prolactin and adipose tissue.” Biochimie 97 (2014): 16–21.
  25. Silvestris, E., de Pergola, G., Rosania, R., et al. “Obesity as disruptor of the female fertility.” Reprod Biol Endocrinol 16.22 (2018). DOI: 10.1186/s12958-018-0336-z

Published

2021-12-29

How to Cite

Tatarchuk, T., Kosei, N., Reheda, S., Hlamazda, M., & Shakalo, I. (2021). Prolactin level correction in restoration of menstrual cycle in obese women. REPRODUCTIVE ENDOCRINOLOGY, (62), 53–58. https://doi.org/10.18370/2309-4117.2021.62.53-58

Issue

Section

Gynecology

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