Hyperprolactinemia

What is hyperprolactinemia?

Hyperprolactinemia is a condition in which the blood values of prolactin are very high compared to the norm. Prolactin is a hormone that is produced by a gland located at the base of the skull and has the function of promoting, in women, the production of milk during pregnancy (galactorrhea) and of participating, together with estrogen, in the development of breasts during puberty. In men, however, it is often associated with sexual desire, gynecomastia and impotence. In fact, one of its functions is to inhibit testosterone and mobilize fatty acids.

Prognosis

Generally, the prognosis of hyperprolactinemia depends on the causes of hyperprolactinemia, the patient’s age and health status.

Symptoms of hyperprolactinemia

One of the symptoms observed in women in cases of hyperprolactinemia are alterations of the menstrual cycle.

  • In women, among other symptoms, we find vaginal dryness, milk production independently of childbirth, reduction of progesterone after ovulation, oligomenorrhea, amenorrhea.
  • In men, symptoms include galactorrhea, gynecomastia (excessive breast development), impotence, decreased sexual desire, sterility, decreased muscle mass, decreased hair.

One of the symptoms observed in women in cases of hyperprolactinemia is alterations of the menstrual cycle.
are alterations of the menstrual cycle.

Diagnosis of hyperprolactinemia

From the diagnostic point of view, it is first necessary to measure prolactin levels in the blood by means of a blood count (blood test). If the amount of prolactin in the blood is high, the patient will undergo radiological examination of the hypothalamo-pituitary area to determine the presence of pituitary microadenomas and adenomas and their extension to the surrounding areas. In the presence of a tumor mass located in the optic chiasm, visual disturbances may be experienced. In this case, a campimetric evaluation (measurement of the visual field) is appropriate.

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What are the causes of hyperprolactinemia?

The state of hyperprolactinemia may be favored by causes derived from physiological, pathological, pharmacological and neurological factors.

The physiological causes are:

  • Pregnancy
  • Puerperium
  • Stress
  • Physical exercise
  • Sleep
  • High protein foods
  • Breastfeeding
  • Sexual activity

Pathological causes are:

  • Pituitary adenoma and prolactinoma (benign prolactin-secreting tumor).
  • Non-secreting adenomas of the pituitary gland
  • Acromegaly
  • Empty sella syndrome
  • Cushing’s syndrome
  • Meningiomas (malignant tumors of the meninges)
  • Dysgerminoma (testicular cancer)
  • Sarcoidosis

Causes derived from the use of certain medications:

  • Tricyclic antidepressants
  • Antiepileptics
  • Antihypertensives
  • Antiemetics (for nausea and vomiting) – Antihistamines (for nausea and vomiting)
  • Antihistamines

Neurological causes:

  • Herpes Zoster lesions
  • Spinal cord injuries

Other causes:

  • Hypothyroidism
  • Renal insufficiency
  • Liver cirrhosis
  • Adrenal gland failure

Treatments for hyperprolactinemia

Asymptomatic hyperprolactinemia does not require any treatment; in all other cases, the treatment to be adopted will always depend on the determining cause.

Which specialist should be consulted?

For a correct diagnosis and treatment of hyperprolactinemia it is necessary to consult the opinion of an expert in Endocrinology.