The Comparison of Side Effects and Patients' Tolerance toward Prolonged use of Vaginal and Oral Bromocriptine

Background: Hyperprolactinemia is a disorder which is present in clinical forms of galactorrhea, infertility, menstrual disturbances, hirsutism and premenstrual syndrome. Bromocriptine is a dopamine agonist and is a drug of choice for the treatment of this disease. However, the patient's tolerance of this drug is also important because of prolonged use, which can sometimes last for years. In the present research, the Bromocriptine’s side effects and its acceptance level on the part of patients were studied comparing the two forms of oral and vaginal use. This study was a single–blind clinical trial. The subjects were clients of the gynecologic clinic with complaints of galactorrhea, menstrual disturbance, hirsutism, or infertility. The sample composed of 180 women (two groups of 90 people) and the length of the study was two years. The subjects were divided into two groups; oral and vaginal. Prior to the study the subjects were examined systemically and gynecologically for other systemic and local complications. After health assurance of the other systems of the body, drugs were administered in the two forms. The data was gathered using a questionnaire and was analyzed by SPSS (V.21).This study showed that the side effects of bromocriptine were 100% in oral users and 43.2% in intra-vaginal users. The most frequent complication in the oral use was nausea (38.9%), and vaginal itching (22.3%) in the intra-vaginal use. Vertigo in oral-form was more frequent as compared to the vaginal form (27.8% versus 2.3%). Hypotension, on the other hand, was seen in 11.2% of the cases among oral-users, whereas this figure among the intra-vaginal users was zero. About 51.2% of the oral-users had more than two side effects. In both groups, however, the highest complications were seen within the first ten days of the treatment (66.7% and 37.8%). It should also be noted that the severity of complications in 31.2% of the oral group and %11 of the vaginal group were so high that resulted in discontinuation of the drug. Conclusion: There is a significant difference in severity and kind of complications between oral and vaginal use of bromocriptine and acceptance and duration of drug intake in vaginal form is found to be more compared to the oral form.