Reproductive hormonal characteristics are a primary influence on the acquisition and maintenance of peak bone mass such that events associated with the reproductive life span and procreation have profound effects on subsequent risk for osteoporosis and fractures. A longer duration of menstruation, either from earlier menarche or later menopause, and the use of estrogen-containing hormonal contraception appear to increase bone mineral density and may reduce fracture risk. Pregnancy and lactation increase bone turnover and decrease bone density, but the effect is subsequently reversed with recovery of density and possible reduction in long-term fracture risk. Conditions that induce amenorrhea or early menopause, and nonestrogen-containing hormonal contraceptives such as depot medroxyprogesterone acetate, are associated with decreased bone density and possibly increased fracture risk. Mechanisms mediating these known or suggested effects are incompletely characterized.

The effects of bromocriptine discontinuation after a 2 year course of therapy on prolactin (Prl) serum levels and the radiological size of the sella turcica were investigated in 16 women with amenorrhoea-galactorrhoea due to prolactinoma. During therapy, all but 2 patients had normalized serum Prl levels, and 4 women with macroprolactinomas exhibited a reduction in the size of the tumour as documented by CT-scanning and tomography of the sellae. After bromocriptine withdrawal and follow-up during 2 additional years, Prl levels remained normal in 6 patients, 2 of them with microprolactinomas and 4 with macroprolactinoma. The remaining 10 women developed hyperprolactinaemia associated with amenorrhoea and galactorrhoea within 3 months after discontinuation of therapy. No tumour expansion was observed in any case during the 4 year observation period. In the present study bromocriptine treatment seemed to result in permanent cure in 6 out of 16 cases of prolactinomas; nevertheless it is difficult to justify an indefinite medical treatment since the natural history of prolactinoma remains unknown. We presently feel that bromocriptine is more appropriate than neurosurgical transsphenoidal exploration for the primary treatment of prolactinomas. Further investigation is needed before a more definitive conclusion regarding the management of prolactinomas can be reached.

En siete pacientes embarazadas que cursaban con un cuadro de hipertiroidismo tratado con metimazol, se hicieron determinaciones de estriol urinario con el fin de vigilar el estado del feto.Se encontro que las cifras del estriol estimado por un metodo colorimetrico, no correspondieron al estado funcional de feto ni ayudaron a predecir su estado neonatal. Se concluye que aunque el grupo de pacientes es pequeno, los resultados indican que se debe tener precaucion en la interpretacion de esta prueba de laboratorio y no conviene utilizarla en la vigilancia de este tipo de pacientes