Overview:
- Hyperprolactinemia is a condition when the pituitary gland produces higher-than-normal levels of the prolactin hormone in the blood.
- Although it can occur in both men and women, it is more common in women under 50 years old.
- The cause of hyperprolactinemia is unknown in about third of cases.
- And the treatment depends on the cause of the elevated serum prolactin.
Introduction:
The pituitary (a small gland in the middle of the head just below the brain) contains lactotroph cells that produce prolactin, the hormone that stimulates lactation (production of breast milk). Prolactinomas occur in both men and women but are more commonly diagnosed in women who are less than 50 years than in older women or men.
Other Names:
hyperprolactinemia, High prolactin (HP)
Cause:
hyperprolactinemia occurs when one of the normal prolactin-producing cells in the pituitary gland develops a mutation. The mutation allows the cell to divide repeatedly, resulting in a large number of cells that produce an excessive amount of prolactin. hyperprolactinemia can be attributable to:
- A small benign tumor or prolactinoma (microadenoma); or
- A large prolactinoma (macroadenoma), which places pressure on the rest of the gland.
However, the cause of hyperprolactinemia, in about third of cases, remains unknown.
Risk factors:
- Pregnancy;
- Hypothyroidism (underactive thyroid);
- Use of some drugs (especially anti-depressants);
- Inflammation of the chest wall (caused by surgical scars, or even brassieres);
- Nipple irritation;
- Renal failure.
Symptoms:
- Vaginal dryness, leading to pain during intercourse;
- Menstrual changes;
- Production of breast milk when not pregnant or nursing;
- Acne;
- Decreased body hair.
When to see a doctor?
On the onset of the above-mentioned symptoms.
Complications:
- Delay of pregnancy;
- Infertility (impotence).
Diagnosis:
The diagnosis of hyperprolactinemia depends on the individual symptoms that the patient develops, as well as their medical history. The diagnosis methods include:
- Clinical examination;
- Lab tests: blood tests;
- Other tests, including: MRI.
Treatment:
Treatment of hyperprolactinemia depends on the cause of the prolactin. It is usually treated through:
- Medications to reduce the production of prolactin;
- A surgery to remove the tumor (prolactinoma) causing high prolactin;
- Treating the tumor by radiation.
Prevention:
Since hyperprolactinemia is often attributed to a hormonal disorder, it has not yet been proved if it can be prevented.
FAQ:
- Do some herbs, such as fenugreek and fennel, stimulate lactation?
Yes, since they stimulate the estrogen hormone, which induces the production of milk.
- Can hyperprolactinemia occur without overt symptoms?
Yes, hyperprolactinemia is usually associated, before menopause, with menstrual disorders. However, after menopause, no hyperprolactinemia-associated symptoms usually appear.
Myths & Realities:
- Tight brassieres can affect the prolactin serum.
Reality: No. However, nipple irritation may result in temporary elevation of prolactin, but without any hyperprolactinemia-associated symptoms.
- Hyperprolactinemia does not affect men.
Reality: Not true; hyperprolactinemia can occur in men. One of the hyperprolactinemia-associated symptoms in men is gynecomastia.