Hyperprolactinemia: Symptoms, Causes & Treatment

Hyperprolactinemia is a condition that could be treated easily. In this one have higher-than-normal levels of prolactin, a hormone, in the blood. While it is not life-threatening, hyperprolactinemia could cause infertility and other issues.

Hyperprolactinemia affects less than 1% of the population. A prolactinoma, a benign, noncancerous, prolactin-releasing tumour is the most common cause of hyperprolactinemia. 

Symptoms of Hyperprolactinemia:

• infertility
• irregular periods
• change in menstrual flow
• pause in menstrual cycle
• loss of libido
• lactation (galactorrhea)
• pain in breasts
• vaginal dryness

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Causes of Hyperprolactinemia:

• Prolactin levels could be elevated due to many reasons. The most common reason is breastfeeding and pregnancy, in which prolactin is naturally elevated. But sometimes pituitary function could be altered by exercise, anorexia, stress, medication, or a medical condition.

• Apart from pregnancy and lactation, other causes of elevated prolactin levels include:

• Hypothyroidism that is an underactive thyroid in which the thyroid gland does not produce enough thyroid hormone

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• Chronic liver or kidney disease.

• Nipple stimulation.

• A growth or tumour in the pituitary gland. Prolactinomas, growths or tumours in the pituitary gland that cause prolactin levels  so as to be high, are called benign. When the tumours are larger than 1 centimetre, they are called macroprolactinomas. These might cause headaches and issues with vision.

• Injuries or conditions which could affect the chest wall.

• Certain medications raise prolactin levels as a side effect. These drugs include:

• Tricyclic antidepressants and SSRIs that are prescribed for anxiety, depression, and other mental health issues.

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• Risperdal and haloperidol which are prescribed for mood disorders, schizophrenia, bipolar disorder and other mental health disorders.

• Calcium-channel blockers and methyldopa which are prescribed for high blood pressure.

• Some medications for heartburn, vomiting, gastroesophageal reflux (GERD) and nausea.

• Opiate pain relievers.

• Birth control pills or oral contraceptives.

• Oestrogen that is prescribed for menopause symptoms.

Treatment of Hyperprolactinemia:

The goal of the treatment is  so as to return prolactin  so as to normal levels. There are a number of standard options  so as to achieve this:-

• The medications Parlodel (bromocriptine) and Dostinex (cabergoline) are known  so as to be effective in reducing prolactin levels and shrinking the pituitary tumours.
• Surgery could sometimes be used  so as to remove a pituitary tumour if the medications are poorly tolerated or not working.
• Radiation, though rarely used, might be suggested if the medicines and surgery have not been effective in the first place.
• Hypothyroidism could be treated with synthetic thyroid hormone so as to bring prolactin levels down.
• If high prolactin levels are caused by prescription drugs then substitute medications should be prescribed.