Morbidity in our patients was principally due to a hormone over-secretion (i.e gastrin leading to ZES and causing ulcers and bleeding; PRL responsible for amenorrhea, oligomenorrhea and/or galactorrhea in women and impotence, infertility, decreased libido in men; insulin provoking hypoglycemia, etc), while mortality was caused, prevalently, by malignant progression and metastases of not early detected gastrinomas and carcinoids. Here, INS is linked to amenorrhea.