Hyperprolactinemia

Prolactin, a hormone produced by the pituitary gland, is best known for its role in supporting lactation. However, its influence extends far beyond breastfeeding. Prolactin impacts reproductive health, immune function, and even mood. When prolactin levels become abnormally high—a condition known as hyperprolactinemia—it can lead to a range of symptoms and health concerns.

What Causes Hyperprolactinemia?

Hyperprolactinemia arises from various physiological, pharmacological, and pathological factors.

  • Physiological Causes: Naturally elevated prolactin levels occur during pregnancy and breastfeeding to support milk production.

  • Medications: Certain drugs, such as antipsychotics, antiemetics, and antidepressants, interfere with dopamine pathways, leading to increased prolactin secretion.

  • Pathological Conditions:

    • Prolactinomas: Benign tumors in the pituitary gland are the most common cause of abnormally high prolactin.

    • Hypothyroidism: Increased levels of thyrotropin-releasing hormone (TRH) in hypothyroidism can stimulate prolactin release.

    • Chronic Illnesses: Conditions like kidney disease or liver dysfunction can impair the clearance of prolactin from the body.

  • Other Causes: Chest wall injuries or surgeries and hypothalamic diseases can also trigger excess prolactin production.

In some cases, no identifiable cause is found, which is referred to as idiopathic hyperprolactinemia.

Symptoms of Hyperprolactinemia

The symptoms of hyperprolactinemia often reflect its impact on reproductive and hormonal health and differ between genders:

In Women:

  • Irregular or absent menstrual cycles (amenorrhea)

  • Unintended milk production (galactorrhea)

  • Infertility due to disrupted ovulation

  • Decreased libido and breast tenderness

In Men:

  • Reduced libido and erectile dysfunction

  • Breast enlargement (gynecomastia)

  • Infertility due to impaired sperm production

  • Loss of body hair

Both men and women may experience symptoms like headaches or vision problems if a prolactinoma compresses surrounding tissues.

Diagnosing Hyperprolactinemia

Diagnosis begins with a simple blood test to measure prolactin levels, often confirmed with a fasting morning sample. Additional steps include:

  • Medical History Review: Identifying potential triggers such as medications or underlying conditions.

  • Imaging: MRI scans of the pituitary gland help detect prolactinomas or other structural abnormalities.

  • Laboratory Tests: Screening for secondary causes like hypothyroidism or kidney disease ensures accurate diagnosis.

Treatment Options

The treatment of hyperprolactinemia depends on the underlying cause and the severity of symptoms. For most cases, dopamine agonists like cabergoline or bromocriptine are the first line of therapy. These medications effectively lower prolactin levels and shrink prolactinomas.

Other options include:

  • Surgery: Transsphenoidal surgery may be necessary for patients who don’t respond to medication or have significant tumor effects.

  • Radiotherapy: Reserved for rare cases of aggressive or resistant prolactinomas.

With appropriate treatment, many patients experience a significant improvement in symptoms and overall health.

Seeking Help for Hyperprolactinemia

Hyperprolactinemia can feel overwhelming, but effective treatments and expert care can make all the difference. Dr. Farhad Hasan specializes in diagnosing and treating conditions like hyperprolactinemia. At Chia Endocrinology & Wellness, Dr. Hasan provides personalized care, helping patients manage symptoms, identify underlying causes, and restore hormonal balance. Whether it’s through medication, lifestyle adjustments, or advanced treatments, Dr. Hasan’s expertise ensures every patient receives the support they need to thrive.

If you’re struggling with symptoms of hyperprolactinemia or searching for answers, schedule a consultation today to start your journey toward better health.

At Chia Endocrinology & Wellness, Dr. Farhad Hasan serves patients across Western Pennsylvania, including the city of Pittsburgh and surrounding areas in Allegheny County such as Ross Township, McCandless, Pine, Marshall, Mars, Richland, Gibsonia, Wexford, Sewickley, Franklin Park, Hampton, Shaler, Findlay, Upper St. Clair, Robinson, North Fayette, Monroeville, and Moon Township. We also serve Butler County, covering Cranberry Township, Seven Fields, Zelienople, Butler, Harmony, and Evans city, as well as patients in nearby Washington County and Beaver County.