Hyperprolactinemia

Hyperprolactinemia – General Information

Patients who suffer from Hyperprolactinemia present unusually elevated levels of prolactin (a hormone) in their blood. In a healthy individual, the proper blood levels of this hormone should be less than 450 mIU/L in the case of male patients and not over 580 mIU/L in the case of female patients. This hormone is up-regulated by estrogen and is down-regulated by dopamine. This is why scientists have concluded that the causes of this medical disorder can be the presence of an inactive macro-prolactin in the individual’s blood serum. Furthermore, this medical disorder can be triggered either by dis-inhibition (reduced dopamine levels, compression of the individual’s pituitary stalk, and so on) or by an excessive secretion of prolactin (this can be due to the presence of an adenoma tumor inside the pituitary gland, called a prolactinoma). If the patient presents between 1000 and 5000 mIU/L levels of prolactin, his or her Hyperprolactinemia can be due to either of the two causes that we have listed above. However, the more severe forms of this medical condition (when the patients’ blood levels of this hormone are higher than 5000 mIU/L), the most probable cause is the presence of a prolactinoma. The presence of this medical condition reduces the release of a hormone (the GnRH - gonadotropin-releasing hormone), as it increases the secretion of dopamine (this substance is provided by the hypothalamus). This is why a patient who suffers from this medical condition will present deficiencies in their regular gonadal steroidogenesis.

Hyperprolactinemia – Symptoms

In the case of female patients who are diagnosed with this medical condition, several clinical cases who presented hypoestrogenism have been reported. This symptom is accompanied by a decrease in the regular menstruation and anovulatory infertility. The severe cases of females with this medical disorder also experienced amenorrhea – the disappearance of menstruation. However, others only present irregular menstruation and changes in their normal menstrual flow. Some female patients who were not nursing a child and were not pregnant started to produce breast milk (due to the presence of Hyperprolactinemia). Some females may also complain of a loss of libido, painful sexual intercourses (these are thought to be due to the abnormal vaginal dryness).

Men patients who were diagnosed with Hyperprolactinemia experienced decreased libido, infertility and erectile dysfunction. As men do not present any reliable indicators that might signal the presence of this medical condition (they do not have menstruation), the diagnosis of this medical condition is set later than in the case of female patients. Male patients only go to their doctor for a medical check when they experience eye disorders and headaches (that are caused by the enlarged pituitary gland that presses their eye nerves). Other men fail to notice a decreased libido or a loss of their sexual function. Only after their therapy for this medical condition ends (when their symptoms ease) they realize that they had had a sexual function problem.

Hyperprolactinemia – Treatment

If you suspect that you are suffering from this medical condition (Hyperprolactinemia) or if you present any of the symptoms and / or signs that we have listed above, we strongly advise you to contact your personal health care provider and establish an emergency medical check up. After asking you about your symptoms, your physician will want you to undergo a series of clinical blood exams that will determine your exact prolactin blood levels. If he or she establishes that your levels are too high, your physician will also order you to undergo a thyroid function medical test. He or she will also want to know if you have recently followed any therapy with medicines that might have increased your organism’s secretion of prolactin.

Some patients with Hyperprolactinemia undergo X-rays of the bones that are found next to their pituitary gland, as this clinical exam will determine if there are any large macro-adenomas in that area. However, the presence of small micro adenomas is not revealed through a plain X-ray. Another effective way to reveal the presence of pituitary tumors is the MRI (magnetic resonance imaging) that also determines the size of the tumors. Such scans ought to be performed periodically in order to enable the physician to closely monitor the effects of the therapy and the progression of the tumor. Another scan, the CT (computed tomography) scan, is able to give a close examination of the gland; however, the CT scan is not as sensitive as the MRI exam.

The direct therapy for individuals who suffer from Hyperprolactinemia aims toward correcting the unpleasant symptoms of this medical condition and towards the reduction of the tumor’s size. Some scientists believe that a potassium channel opener known as Minoxidil may be another cause that leads to the appearance of this medical condition. Laboratory tests have been performed in order to confirm such suspicions. A set of rats that were administered this drug for two years developed pheochromocytomas (both female and male individuals) and also preputial gland adenomas (in the case of male individuals).This is why, if the physician has established that the patient’s abnormally high levels of blood prolactin are due to the intake of a certain medical product, then that specific therapy ought to be immediately stopped. If the patient’s condition is due to hypothyroidism, he or she should immediately start an appropriate therapy with a thyroid hormone. Idiopathic medical cases (patients who suffer from Hyperprolactinemia but do not present the signs and / or symptoms that are specific to this medical condition) needn’t follow a therapy for this disorder. Their condition ought to be carefully monitored by an authorized health care provider.

The radiation therapy is another viable option for those who suffer from Hyperprolactinemia and it is recommended in the case of rapidly developing tumors. Other patients are prescribed a medication therapy with dopamine antagonists. The most popular of them is Bromocriptine Mesylate that is usually the first choice of any doctor in the treatment of this medical condition. Other drugs that are included in the same category are: Carbegoline, Guinagolide, and so on.