Hyperprolactinemia (pronounced as hyper – prolactin – emia) is a very common condition where a person has more prolactin than is normal or required in their body.
Every person produces the prolactin hormone mainly in the pituitary gland, which is a little hormone-secreting gland situated at the base of the brain.
Prolactin is a very vital hormone as it has several roles to play in many bodily functions, including ovulation, reproduction, immunity, and even blood cell formation.
Nevertheless, the primary purpose of the prolactin hormone is to stimulate lactation.
A case of hyperprolactinemia must be attended to immediately, as cases that are left unmanaged can impact a person’s fertility and bone density, leading to osteoporosis.
In many cases, it can also cause neurological symptoms. Early diagnosis and proper treatment can go a long way to help reduce risks and possible complications connected with such conditions.
Symptoms of hyperprolactinemia
Hyperprolactinemia tends to most noticeably affect reproductive organs and function. This occurs because prolactin suppresses luteinizing hormone (LH) and follicle stimulating hormone (FSH) (2).
A person who is dealing with hyperprolactinemia may experience:
- Anovulation (when an egg is not released during a menstrual cycle
- Long or irregular cycles
- Amenorrhea (absence of periods)
- Oligomenorrhea (irregular periods)
- Hirsutism (abnormal hair growth)
- The production and discharge of breast milk
- Sexual side effects
- Neurological symptoms,
- Like headaches or issues with their vision (this is rare).
People who are postmenopausal and people of both genders can also deal with hyperprolactinemia, though the symptoms they deal with may differ.
Hyperprolactinemia may be caused by other medical conditions that lead to hormonal imbalances in the body, some medications, and growths on the pituitary gland.
About 2 out of every 5 cases of Hyperprolactinemia do not have an identifiable cause.
Hormonal interference or damage to the pituitary gland are factors that can cause hyperprolactinemia.
The pituitary gland and hypothalamus (this is the brain’s hormone command center) function together to regulate the different hormones in the human body, such as prolactin.
Some individuals grow a small tumor in their pituitary gland known as a prolactinoma, which is able to cause the release of more prolactin. These tumors are quite uncommon. About 3 to 5 out of every 10,000 individuals have a prolactinoma.
There are a number of things that can cause damage to the pituitary gland, and some include physical trauma, tumors or cysts, or other illnesses or syndromes such as Cushing’s disease.
Metabolic or hormonal conditions
Another factor that may affect the excess production of prolactin includes damage to other parts of the body. In particular, damages to or illnesses of the kidneys, thyroid, and liver can cause hyperprolactinemia.
Hyperprolactinemia has also been connected with other common reproductive disorders, such as polycystic ovary syndrome (PCOS) and amenorrhea. Almost 1 in 6 people who have PCOS also have hyperprolactinemia.
Another very common fact that may cause hyperprolactinemia includes a person’s behavior. Excessive workout, stress, and lack of sleep can interfere with the proper function of your hormones, and this will lead to the disorder.
There are some medications that can cause hyperprolactinemia. Such medications include:
- Narcotics, such as opioids
- Psychotropic drugs like dopamine-blocking psychotropic/antipsychotic drugs
- Drugs are taken to treat high levels of stomach acid or treat ulcers
- Medications that contain Estrogen, though this is usually slight and rarely requires treatment
Pregnancy and breastfeeding
Usually, a high level of prolactin in the body is considered normal during and after pregnancy, most especially while breastfeeding
How is hyperprolactinemia diagnosed?
Typically, hyperprolactinemia is diagnosed through blood tests.
If individual tests positive for hyperprolactinemia and has no clinical symptoms, there’s a possibility that the test is only picking up macroprolactins, or also picking up prolactins molecules that are much larger than usual.
This is a form of prolactin that affects the body differently, so treatment and management may differ or may not be required, depending on the situation.
For the treatment of hyperprolactinemia caused by medicine, a doctor or healthcare provider may have to tell you to consider using a new medication, or adding a new drug to balance out some of the side effects of the first medication.
In these cases, it is essential to discuss all preferences and concerns with regards to the side effects and management of other medical challenges.
For hyperprolactinemia that is caused by a benign tumor on a person’s pituitary gland (prolactinoma), a doctor or healthcare provider may have to recommend medications that will affect dopamine function (these are known as dopamine agonists).
The healthcare professional may also suggest hormone therapy, either in the form of hormone replacement therapy (HRT) or hormonal contraceptives.
In cases where it has become impossible for medication or hormones to treat the tumor, a doctor or healthcare provider may recommend surgery.
When this cause of hyperprolactinemia is being treated, it is imperative for the healthcare provider to first figure out a patient’s pregnancy status and pregnancy intentions.
This is because some of the medications that are used for the treatment of such tumors may negatively affect pregnancy or a developing fetus.
What you need to track
- Bleeding patterns
- Abnormal breast discharge
Prolactin is a natural hormone that is most popular for stimulating lactation (this is a term for breast milk production), but it is also involved in bodily functions, including reproduction, ovulation, immunity, and the formation of blood cells.
Hyperprolactinemia is a condition that is characterized by an abnormally high level of prolactin in a person’s body
People who have hyperprolactinemia may experience symptoms such as irregular or absent menstrual periods, infertility, abnormal breast milk discharge, and sexual side effects.
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