Horm Metab Res 2023; 55(04): 266-272
DOI: 10.1055/a-2042-0712
Original Article: Endocrine Care

Reduced Health Related Quality of Life, Increased Fatigue, and Daytime Sleepiness in Women with Hyperprolactinemia

1   Department of Health, Medicine and Caring Sciences, Division of Nursing Science and Reproductive Health, Linköping University, Linköping, Sweden
,
Margareta Bachrack-Lindström
1   Department of Health, Medicine and Caring Sciences, Division of Nursing Science and Reproductive Health, Linköping University, Linköping, Sweden
,
Eva Landberg
2   Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linkoping, Sweden
,
3   Department of Endocrinology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
,
4   Faculty of Medical Sciences, Örebro University, Örebro, Sweden
3   Department of Endocrinology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
› Author Affiliations
Funding Information Forskningsrådet i Sydöstra Sverige — http://dx.doi.org/10.13039/ 100010805; 4065

Abstract

Prolactin has many physiological effects and seems to be involved in the human quality of life and well-being. The aim of this study was to describe health related quality of life, fatigue and daytime sleepiness in women with untreated hyperprolactinemia. In total 32 women (mean age 37.0±10.9 years) with verified hyperprolactinemia completed a questionnaire including questions on fatigue, measured with the Swedish version of the Fatigue Impact Scale (FIS), propensity to fall in sleep, measured with the Swedish version of the Epworth Sleepiness Scale (ESS), and Health related quality of life (HRQoL), measured by the Short-Form-36 scale (SF-36). For comparison Swedish normative data were used. The women were also interviewed regarding different symptoms related to hyperprolactinemia and the answers were analyzed using qualitative content analysis. HRQoL, as measured with SF-36, was significantly lower in all dimensions, except in physical function, compared to the Swedish reference population. Total FIS was 54.3 (41.1) and mean score on the ESS was 8.7 (4.2) indicating increased fatigue and deterioration in night sleep. The women felt very tired, and several of them rarely felt rested in the morning. The restless night sleep and the fatigue during the daytime got them to feel feeble and sometimes to find it difficult to concentrate, which affected both their mood and life in general. Women diagnosed with hyperprolactinemia reported deterioration in night sleep, increased rate of fatigue, and a reduced health related quality of life in comparison with the reference population.



Publication History

Received: 11 September 2022

Accepted after revision: 23 February 2023

Accepted Manuscript online:
23 February 2023

Article published online:
05 April 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Freeman ME, Kanyicska B, Lerant A. et al. Prolactin: structure, function, and regulation of secretion. Physiol Rev 2000; 80: 1523-1631
  • 2 Goffin V, Binart N, Touraine P. et al. Prolactin: the new biology of an old hormone. Annu Rev Physiol 2002; 64: 47-67
  • 3 Shelly S, Boaz M, Orbach H. Prolactin and autoimmunity. Autoimmun Rev 2012; 11: A465-A470
  • 4 Ezzat S, Asa SL, Couldwell WT. et al. The prevalence of pituitary adenomas: a systematic review. Cancer 2004; 101: 613-619
  • 5 Dorshkind K, Horseman ND. The roles of prolactin, growth hormone, insulin-like growth factor-I, and thyroid hormones in lymphocyte development and function: insights from genetic models of hormone and hormone receptor deficiency. Endocrine Rev 2000; 21: 292-312
  • 6 Ewerman L, Landberg E, Hellberg S. et al. Immunomodulating effects depend on prolactin levels in patients with hyperprolactinemia. Horm Metab Res 2020; 52: 228-235
  • 7 An FR, Yang R, Wang ZM. et al. Hyperprolactinemia, prolactin-related side effects and quality of life in Chinese psychiatric patients. Compr Psychiatry 2016; 71: 71-76
  • 8 Bargiota SI, Bonotis KS, Messinis IE. et al. The effects of antipsychotics on prolactin levels and women’s menstruation. Schizophr Res Treatment 2013; 502697
  • 9 Bukowska A, Sobala W, Peplonska B. Rotating night shift work, sleep quality, selected lifestyle factors and prolactin concentration in nurses and midwives. Chronobiol Int 2015; 32: 318-326
  • 10 Kinon BJ, Stauffer VL, McGuire HC. et al. The effects of antipsychotic drug treatment on prolactin concentrations in elderly patients. J Am Med Dir Assoc 2003; 4: 189-194
  • 11 Notsu K, Ito Y, Furuya H. et al. Incidence of hyperprolactinemia in patients with Hashimoto’s thyroiditis. Endocr J 1997; 44: 89-94
  • 12 Sobrinho LG. Prolactin, psychological stress and environment in humans: adaptation and maladaptation. Pituitary 2003; 6: 35-39
  • 13 Wong J, Seeman MV. Prolactin, menstrual irregularities, quality of life. Schizophr Res 2007; 91: 270-271
  • 14 Cesar de Oliveira Naliato E, Dutra Violante AH, Caldas D. et al. Quality of life in women with microprolactinoma treated with dopamine agonists. Pituitary 2008; 11: 247-254
  • 15 Kars M, van der Klaauw AA, Onstein CS. et al. Quality of life is decreased in female patients treated for microprolactinoma. Eur J Endocrinol 2007; 157: 133-139
  • 16 Raappana A, Pirila T, Ebeling T. et al. Long-term health-related quality of life of surgically treated pituitary adenoma patients: a descriptive study. ISRN Endocrinol 2012; 675310
  • 17 Leistner SM, Klotsche J, Dimopoulou C. et al. Reduced sleep quality and depression associate with decreased quality of life in patients with pituitary adenomas. Eur J Endocrinol 2015; 172: 733-743
  • 18 Ioachimescu AG, Fleseriu M, Hoffman AR. et al. Psychological effects of dopamine agonist treatment in patients with hyperprolactinemia and prolactin-secreting adenomas. Eur J Endocrinol 2019; 180: 31-40
  • 19 De Schepper J, Schiettecatte J, Velkeniers B. et al. Clinical and biological characterization of macroprolactinemia with and without prolactin-IgG complexes. Eur J Endocrinol 2003; 149: 201-207
  • 20 Shimatsu A, Hattori N. Macroprolactinemia: diagnostic, clinical, and pathogenic significance. Clin Develop Immunol 2012; 167132
  • 21 Gibney J, Smith TP, McKenna TJ. The impact on clinical practice of routine screening for macroprolactin. J Clin Endocrinol Metab 2005; 90: 3927-3932
  • 22 Strachan MW, Teoh WL, Don-Wauchope AC. et al. Clinical and radiological features of patients with macroprolactinaemia. Clin Endocrinol (Oxford) 2003; 59: 339-346
  • 23 Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24: 105-112
  • 24 Sullivan M, Karlsson J, Taft C. SF-36 Health survey: Swedish manual and interpretation guide. Sahlgrenska University Hospital, Gothenburg. 2002 2nd Edition
  • 25 Taft C, Karlsson J, Sullivan M. Do SF-36 summary component scores accurately summarize subscale scores?. Qual Life Res 2001; 10: 395-404
  • 26 Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). Conceptual framework and item selection. Med Care 1992; 30: 473-483
  • 27 Flensner G, Ek AC, Soderhamn O. Reliability and validity of the Swedish version of the fatigue impact scale (FIS). Scand J Occup Ther 2005; 12: 170-180
  • 28 Fisk JD, Ritvo PG, Ross L. et al. Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clin Infect Dis 1994; 18: S79-S83
  • 29 Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep Med 1991; 14: 540-545
  • 30 Johns MW. Reliability and factor analysis of the Epworth sleepiness scale. Sleep Medicine 1992; 15: 376-381
  • 31 Crespo I, Valassi E, Santos A. et al. Health-related quality of life in pituitary diseases. Endocrinol Metab Clin North Am 2015; 44: 161-170
  • 32 Molitch ME. Diagnosis and treatment of pituitary adenomas: a review. JAMA 2017; 317: 516-524
  • 33 Johnson MD, Woodburn CJ, Vance ML. Quality of life in patients with a pituitary adenoma. Pituitary 2003; 6: 81-87
  • 34 Swedish Prescribed Drug Registry Sweden National Board of Health and Welfare 2019
  • 35 Pereira HS, Naliato EC, Moraes AB. et al. Body self-image disturbances in women with prolactinoma. Braz J Psychiatry 2020; 42: 33-39
  • 36 Andela CD, Niemeijer ND, Scharloo M. et al. Towards a better quality of life (QoL) for patients with pituitary diseases: results from a focus group study exploring QoL. Pituitary 2015; 18: 86-100
  • 37 Magnusson JE, Riess CM, Becker WJ. Modification of the SF-36 for a headache population changes patient-reported health status. Headache 2012; 52: 993-1004