Hyperprolactinemia in some Ménière patients even in the absence of incapacitating vertigo

Stress can be a significant factor influencing ear pathologies and is often reported to trigger the symptoms of Ménière's disease. Both physiological and psychological stress provokes the release of prolactin from the pituitary thus allowing the classification of prolactin as a major stress hormone. We investigated the level of the stress hormone prolactin in a Swedish population with early symptoms of Ménière's disease. The median prolactin level in the Ménière patients (n = 33) was not significantly different from that of non-Ménière patients (n = 23). However, in the Ménière group one female (90 year old) had prolactin levels in the upper normal range for women, one male (77 year old) had prolactin levels above the normal limit for men, and a third patient (76 year old female) presented hyperprolactinemia with more than twice the normal level. MRI confirmed a pituitary adenoma in this patient. This study provides further support for the recent report of hyperprolactinemia in some patients with long-standing Ménière's disease and presenting incapacitating vertigo in France. The data emphasize the likely implication of stress in this pathology where the stress hormone prolactin is likely to represent one actor in a complex hormonal imbalance affecting the inner ear.