Hyperprolactinemia is a condition in which a person has a higher-than-normal level of the hormone prolactin in the blood . The main function of prolactin is to stimulate breast milk production after delivery, so high prolactin levels are normal during pregnancy. Prolactin also affects sex hormone levels ( estrogen and testosterone) in both men and women . Prolactin is made by the pituitary gland , a pea-sized organ located at the base of the brain .
A common cause of hyperprolactinemia is a growth or tumor in the pituitary gland called a prolactinoma. The tumor produces high levels of prolactin. These tumors can be large or small and are usually benign, meaning they are not cancerous. Small tumors (less than 1 cm) are called microprolactinomas and larger tumors (greater than 1 cm) are called macroprolactinomas. Large tumors can also cause headaches, vision problems, or both. Prolactinomas are more common in women than men and rarely occur in children. Other causes could be:
– Hypothyroidism (low thyroid hormone levels)
– Liver cirrhosis
– Chronic kidney failure
What are the signs and symptoms of hyperprolactinemia?
Infertility, decreased sex drive, and bone loss can occur in both men and women. In addition, women may include:
- Vaginal dryness that causes pain during sexual intercourse
- Mens cycle issues
- Production of breast milk when pregnant or not breastfeedingMen can also include:
- erectile dysfunction
- breast enlargement called gynecomastia
Reduction in muscle mass and body hair
How is hyperprolactinemia diagnosed?
A blood test is used to detect excess prolactin. If prolactin levels are high, more tests are usually done to check blood levels of thyroid hormone. Normal thyroid hormone levels rule out hypothyroidism as a cause of hyperprolactinemia.
If a prolactinoma is suspected, an MRI (magnetic resonance imaging) of the brain and pituitary is taken. MRI can reveal a pituitary tumor and show its size using a special machine that creates images of body tissues.
TREATMENT OF HYPERPROLACTINEMIA
The goal of treatment is to return prolactin to normal levels. There are a number of standard options to achieve this:
It is known that drugs such as Parlodel (bromocriptine) and Dostinex (cabergoline) are effective in reducing prolactin levels and shrinking pituitary tumors.
Sometimes surgery can be used to remove the pituitary tumor if it doesn’t work or is poorly tolerated.
- In cases where medication and surgery are not effective, radiation may rarely be recommended.
- Hypothyroidism can be treated with synthetic thyroid hormone, which should lower prolactin levels.
- If prescription medications are causing high prolactin levels, alternative medications may be prescribed.