Hyperprolactinemia

Hyperprolactinemia is elevated serum prolactin. Etiology: prolactinoma, pharmacologic dopamine antagonism (antipsychotics, metoclopramide), primary hypothyroidism, pituitary-stalk compression, chest-wall stimulation, stress, renal/hepatic failure. It causes hypogonadotropic hypogonadism: amenorrhea/oligomenorrhea, galactorrhea, infertility in women; hypogonadism and sexual dysfunction in men. Macroprolactinemia (asymptomatic big prolactin) must be excluded.

Common Symptoms

Galactorrhea; menstrual disturbance; infertility; sexual dysfunction; headache; visual-field defect; low libido

Causes and Pathogenesis

Loss of dopaminergic prolactin inhibition or autonomous lactotroph adenoma raises prolactin, which suppresses hypothalamic GnRH and reduces gonadotropin/sex-steroid production.

Treatment

Dopamine agonists (cabergoline/bromocriptine); review/withdraw offending drugs; treat hypothyroidism; transsphenoidal surgery for resistant macroadenoma

Preventive Measures

Screen medications/thyroid; MRI pituitary for persistent elevation; manage macroprolactin; fertility planning.

Department to Visit

It is recommended to visit the Endocrinology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.