Hyperprolactinemia

Hyperprolactinemia is elevated serum prolactin. Causes: prolactinoma (pituitary lactotroph adenoma), medications (dopamine antagonists - antipsychotics, metoclopramide), primary hypothyroidism, chest-wall injury, stress, pregnancy, renal/hepatic failure. Clinical: in women - galactorrhea, amenorrhea, oligomenorrhea, infertility; in men - hypogonadism, erectile dysfunction, infertility, often few symptoms. Macroprolactin must be excluded.

Common Symptoms

Galactorrhea; menstrual irregularity/amenorrhea; erectile dysfunction; infertility; headache; visual field defect if macroadenoma

Causes and Pathogenesis

Dopamine is the principal prolactin-inhibiting factor; loss of dopaminergic tone (drugs, stalk compression) or autonomous lactotroph proliferation raises prolactin, suppressing GnRH/gonadotropins.

Treatment

Dopamine agonists (bromocriptine, cabergoline) for prolactinoma; stop offending drugs if possible; treat hypothyroidism; surgery/radiotherapy for resistant macroadenoma

Preventive Measures

Review medications; screen thyroid; evaluate pituitary MRI; manage macroprolactin asymptomatic.

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.