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Hyperprolactinemia

Description

Hyperprolactinemia is a condition in which the pituitary gland starts producing abnormally high levels of prolactin hormone. The function of prolactin is to stimulate breast milk production, therefore, high levels of this hormone in a pregnant and lactating female are normal. Hyperprolactinemia can cause a number of reproductive disorders as prolactin also influences the presence of sex hormones (estrogen and testosterone) in females and males.

Causes

Causes of hyperprolactinemia can be classified into 5 broad categories which are:

  1. Physiologic conditions that stimulate the pituitary gland to produce excess prolactin. These include pregnancy, lactation, sleep, stress, and chest wall stimulation.
  2. Hypothalamus-pituitary stalk damage which could be due to tumors, granulomas, irradiation, and trauma.
  3. Pituitary hypersecretion is caused by disorders of the pituitary gland itself such as prolactinoma (tumor), acromegaly (gigantism), and Laron syndrome (body fails to utilize growth hormone).
  4. Systemic disorders such as chronic (long term) kidney failure, hypothyroidism (low levels of thyroid hormones), cirrhosis (hardening of organs), and epileptic seizures (abnormal brain activity characterized by periods of unconsciousness).
  5. Medicine induced pituitary hypersecretion. Certain medicines like dopamine receptor blockers, opiates, calcium channel blockers, hormones, tricyclic anti-depressants cause hyperfunctioning of pituitary gland.
Risk factors

Common risk factors of hyperprolactinemia include:

  • Radiation therapy,
  • Prolonged intake of medicines and drugs that contain alcohol or marijuana,
  • Pregnancy,
  • Thyroid gland failure,
  • Patients taking antipsychotic medicines.
Symptoms

Symptoms of hyperprolactinemia are different in men and women. In females, hyperprolactinemia can produce the following symptoms:

  • Infertility,
  • Irregular menstrual cycle,
  • Change in menstrual flow,
  • Menopause (cessation of menstrual cycle),
  • Galactorrhea (production of breast milk in women who are not pregnant or nursing),
  • Pain in breasts,
  • Vaginal dryness

In males:

  • Gynecomastia (abnormal breast growth),
  • Galactorrhea (production of breast milk in males),
  • Infertility,
  • Erectile dysfunction (cannot maintain an erection),
  • Loss of sexual desire,
  • Headaches,
  • Change in vision.
Diagnosis

To reach a diagnosis, your doctor will take your thorough medical history, may ask you to get some laboratory investigations like blood tests done, if your blood tests show high prolactin levels then your doctor may ask you to get a CT scan or MRI done to find out the etiological factor, will take your detailed menstrual history if you are a female, and will ask specific questions related to your symptoms.

Management

The main aim of treatment is to bring prolactin level back to normal. Treatment plan will base entirely on the cause of hyperprolactinemia. In case of a tumor, a tumor removal surgery will suffice for lowering prolactin level. In case of thyroid gland failure, administration of synthetic thyroid hormones will be the adequate measure. In case of medicine induced hyperprolactinemia, administration of certain medicines like bromocriptine will be the appropriate step.

When to consult a doctor?

You are advised to consult a doctor if there is worsening of your condition, no improvement in your symptoms, new side effects from the therapeutic measures being taken, and if your condition starts causing you physical and emotional distress.

Available Medicine for Hyperprolactinemia

Bromicon 2.5mg

Rs.125.33

Helicon

Brotin 2.5mg

Rs.220.52

Shaigan

Parlodel 2.5mg

Rs.179.09

Novartis

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