Hyperprolactinemia in Males and Females
What Is Hyperprolactinemia?
Hyperprolactinemia is a condition where an individual has higher-than-normal levels of the hormonal agent prolactin in the blood. The main function of prolactin is to stimulate breast milk production after giving birth, so high prolactin levels are normal in pregnancy. Prolactin also affects the levels of sex hormonal agents (estrogen and testosterone) in both women and men. Prolactin is made by the pituitary gland, a pea-sized organ discovered at the base of the brain.
One typical reason for hyperprolactinemia is a growth or growth on the pituitary gland called a prolactinoma. The tumor produces high levels of prolactin. These tumors can be large or little and are generally benign, implying they are not cancerous. Large tumors can likewise cause headaches, vision problems, or both. Prolactinomas are more typical in women than in men and seldom occur in kids.
Specific prescription medications can also increase prolactin levels. These include medications for:
- Hypertension (such as calcium-channel blockers and methyldopa).
- Anxiety (tricyclic and SSRI antidepressants).
- Heartburn and gastroesphageal reflux disease.
- Queasiness and throwing up.
- Pain (opiates — drugs derived from opium).
- Serious mental health conditions (antipsychotics such as risperdal and haloperidol).
- Menopausal symptoms (estrogen).
Other causes consist of:
- Hypothyroidism or underactive thyroid– meaning the thyroid gland does not produce sufficient thyroid hormonal agent.
- Chest-wall injuries or other conditions that affect the chest wall, such as shingles.
- Other growths and diseases impacting the pituitary gland, or radiation treatment for growths on or near the pituitary.
- Chronic liver and kidney diseases.
In some cases, no cause for hyperprolactinemia can be found.
How Does Hypothyroidism Cause Hyperprolactinemia?
In the research study of hyperprolactinemia is needed the decision of thyroid hormonal agents, although imaging test is observed pituitary augmentation which can be thought about as prolactinoma, because levothyroxine replacement therapy in cases of serious hypothyroidism to regularize both, hormone levels and pituitary hyperplasia, avoiding unnecessary treatments (dopamine agonist) or even neurosurgery.
Both men and women may have infertility, decreased sex drive, and bone loss. In addition, women may have:
- Vaginal dryness, causing pain throughout sexual intercourse.
- Issues with menstruation– having no periods or irregular periods.
- Production of breast milk when not pregnant or nursing.
Signs of Hyperprolactinemia in Men
- Impotence — trouble getting or keeping an erection.
- Breast augmentation, called gynecomastia.
- Decreased muscle mass and body hair.
A blood test is used to detect excess prolactin. If prolactin levels are high, more tests are normally done to check blood levels of thyroid hormone. Normal thyroid hormonal agent levels dismiss hypothyroidism as a cause of hyperprolactinemia. Doctors will likewise inquire about other conditions and medication use, and rule out pregnancy.
If a prolactinoma is suspected, an MRI (magnetic resonance imaging) of the brain and pituitary is often the next step. Utilizing an unique device that produces images of body tissues, an MRI can reveal a pituitary tumor and reveal its size.
Treatment is based upon the cause. Some individuals with high prolactin levels, however few or no signs and symptoms, do not require any treatment. Choices for treating growths include:
- Prescription medications. Bromocriptine and cabergoline decrease prolactin production. Medicines work well for most people with prolactinomas.
- Surgery to eliminate a tumor. Surgery may be used if medicines have actually not been effective. Surgery is sometimes required if the growth is impacting vision.
- Radiation. Seldom, if medicines and surgery have not worked, radiation is utilized to shrink the tumor.
Bromocriptine and cabergoline are also used to deal with hyperprolactinemia without any known cause. Hypothyroidism is treated with artificial thyroid hormone, which must bring prolactin levels back to normal. If high prolactin levels are triggered by prescription medications, other types of medications can be explored.
What to Ask Your Doctor
What caused my hyperprolactinemia?
What tests do I require?
What are my alternatives for treatment?
What are the benefits and downsides of each treatment alternative?
Will I have long-term side effects from my condition?