What is Hyperprolactinemia? Causes

Hyperprolactinemia is a condition characterized by an increased content of prolactin (a pituitary hormone) in the blood. Most often, hyperprolactinaemia occurs in young women aged 25-40 years, much less often - in men of the same age.

Causes

The causes that lead to increased production of prolactin are diverse:

  • 1. The tumor (adenoma) of the pituitary gland is the most common cause of this condition. Usually, such tumors have small dimensions (no more than 2-3 mm). By the word "swelling" doctors denote an increase in the size of the pituitary gland, it is not a cancer, but a benign formation.
  • 2. Decreased thyroid function (hypothyroidism).
  • 3. Diseases of the ovaries (polycystic ovary syndrome).
  • 4. Acceptance of some drugs: antiemetics (cerucal), antidepressants (amitriptyline), contraceptives with a high estrogen content.
  • 5. Cirrhosis of the liver.
  • 6. Chronic renal failure (hyperprolactinemia occurs in 65% of patients on hemodialysis).
  • 7. Diseases of the brain (meningitis, encephalitis, tumors).

What's happening?

Women with hyperprolactinemia syndrome, as a rule, are concerned about the allocation of milk from the breasts outside of pregnancy (galactorrhea), infertility and menstruation (most often their absence). Men are concerned about a decrease in sexual desire and potency, sometimes in conjunction with the allocation of milk. In some cases, excessive growth of hair on the body, a tendency to acne. As the tumor of the pituitary gland grows, visual impairment may occur, a headache.

Diagnosis and treatment

Diagnosis and treatment of hyperprolactinemia is handled by an endocrinologist, as well as a gynecologist-endocrinologist. For diagnostics it is necessary:

  • take a blood test for prolactin (the blood is taken from the vein), in addition, the doctor can prescribe hormonal samples;
  • In some cases, a blood test for other hormones, for example thyroid hormones (if the doctor suspects a thyroid dysfunction) is required;
  • perform an x-ray of the skull and the area of ​​the Turkish saddle to assess the size of the pituitary gland;
  • for a detailed assessment of the pituitary gland and the surrounding parts of the brain, tomography - computer (CT), based on the use of X-rays, and magnetic resonance (MRI), based on the use of magnetic fields;
  • consultation with a gynecologist (for women);
  • if an adenoma of the pituitary gland is detected, an oculist will need to consult.

If hyperprolactinaemia is caused by hypothyroidism or adrenal insufficiency, appropriate hormone replacement therapy is prescribed, which leads to a normalization of prolactin production and the halactorrhea termination.

If the condition is associated with taking medications (cerucal, amitriptyline, etc.), these drugs are canceled. As a rule, after 4-5 weeks after this, the menstrual cycle is restored and the galactorrhea ceases. Therapeutic treatment is most often used. Patients are prescribed special drugs (parlodel, lizard, etc.). Such therapy normalizes the content of prolactin in the blood, in women restores the menstrual cycle and the ability to conceive.

Surgical intervention (removal of the tumor of the pituitary gland) is used, as a rule, in the presence of visual impairment and inefficiency of therapeutic treatment. Radiation therapy is used most often as an additional method of treatment after hypophysectomy or on the background of therapeutic treatment.

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