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Quality of life is decreased in female patients treated for microprolactinoma

Portuguese Cancer Institute-Endocrinology, Rua Prof. Lima Basto, Lisboa 1099-023, Portugal

(Correspondence should be addressed to L G Sobrinho; Email: luis.g.sobrinho{at}sapo.pt)

In the August issue of the European Journal Endocrinology, Kars et al. (1) reported that quality of life of female patients treated for microprolactinoma is decreased when compared with that of appropriately chosen controls. These observations were independent of the current values of serum prolactin and of current intake, or not, of dopamine agonists, their composition or dosage. The Authors speculated that the decreased quality of life might depend on the past exposure of the brain or of other tissues to hyperprolactinemia or on the disclosure of the diagnosis of a pituitary tumor.

There is a third, alternative, explanation. Life events have been reported to often precede the clinical onset of prolactinomas (2, 3). Also, paternal deprivation early in life has been reported with unusual frequency in women with prolactinomas (2, 4). Both sets of observations indicate that environmental factors may play a role in the clinical expression of prolactinomas. It is, therefore, likely that prolactinomas develop preferentially in women predisposed to activate prolactin secretion in response to some stresses, either because they were primed early in life by paternal deprivation or for some other reasons. These women may also be particularly vulnerable to anxiety and depression. In short, anxiety, depression, and other features of poor quality of life may depend on pre-existent characteristics of women prone to develop prolactinomas and not on the effects of hyperprolactinemia or on the presence of a (small) pituitary mass. Hence their persistence after successful treatment of hyperprolactinemia. This possibility has been recently reviewed in detail (5).

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1. Kars M, van der Klaaw A, Onstein CS, Pereira AM & Romijn JA. Quality of life is decreased in female patients treated for microprolactinoma. European Journal of Endocrinology 2007; 157: 133–139.[Abstract/Free Full Text]
2. Nunes MCP, Sobrinho LG, Calhaz-Jorge C, Santos MA, Mauricio JC & Sousa MFF. Psychosomatic factors in patients with hyperprolactinemia and/or galactorrhea. Obstetrics and Gynecology 1980; 64: 465–468.
3. Sonino N, Navarrini C, Fallo F, Boscaro M & Fava GA. Life events in the pathogenesis of hyperprolactinemia. European Journal of Endocrinology 2004; 151: 61–65.[Abstract]
4. Assies J, Vingerhoets AJJM & Poppelaars K. Psychosocial aspects of hyperprolactinemia. Psychoneuroendocrinology 1992; 17: 673–679.[Web of Science][Medline]
5. Sobrinho LG. Prolactin, psychological stress and environment in humans: adaptation and maladaptation. Pituitary 2003; 6: 35–39.[CrossRef][Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sobrinho, L. G Search for Related Content PubMed PubMed Citation Articles by Sobrinho, L. G