Hyperprolactinemia

Hyperprolactinemia is a condition characterized by elevated levels of prolactin, a hormone produced by the pituitary gland. Prolactin plays a critical role in lactation and other reproductive functions, but excessive levels can lead to various health concerns, including infertility, menstrual irregularities, and sexual dysfunction. This condition can affect both men and women, though it is more commonly diagnosed in women of reproductive age.

Causes of Hyperprolactinemia

Hyperprolactinemia can result from several factors, including:

• Pituitary Tumors: Prolactinomas, benign tumors in the pituitary gland, are the most common cause of high prolactin levels.
• Medications: Certain drugs, such as antipsychotics, antidepressants, and high-dose estrogen, can increase prolactin production.
• Hypothyroidism: Low thyroid hormone levels can stimulate the release of prolactin.
• Other Causes: Stress, chest wall injuries, and chronic kidney disease can also contribute to elevated prolactin levels.

Symptoms of Hyperprolactinemia

Symptoms vary depending on the individual and severity of the condition:

• In Women: Irregular or absent menstrual cycles, galactorrhea (milk production unrelated to breastfeeding), and infertility.
• In Men: Decreased libido, erectile dysfunction, gynecomastia (enlarged breast tissue), and infertility.
• General: Headaches or vision disturbances, especially if a tumor is compressing nearby structures.

Diagnosis of Hyperprolactinemia

Diagnosing hyperprolactinemia involves blood tests to measure prolactin levels. If elevated levels are detected, further tests, such as thyroid function tests and imaging studies like MRI, may be performed to identify the underlying cause, such as a pituitary tumor.

Treatment Options

Treatment focuses on addressing the underlying cause and managing symptoms:

• Medications: Dopamine agonists, such as cabergoline or bromocriptine, are the first-line treatment for prolactinomas and effectively reduce prolactin levels.
• Surgery: For large tumors unresponsive to medication, surgery may be necessary.
• Thyroid Hormone Replacement: Hypothyroidism-related hyperprolactinemia is treated by normalizing thyroid hormone levels.
• Lifestyle Changes: Managing stress and avoiding medications that raise prolactin levels can help reduce symptoms.