Hyperprolactinaemia (patient information)

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 * Associate Editor(s)-In-Chief: Jinhui Wu, M.D.

Overview
Hyperprolactinaemia is the disorder of high levels of prolactin in the blood. It may be caused by prolactinoma, pituitary tumors, chronic renal failure, polycystic ovary syndrome and stress. Sometimes the doctor can not find any cause in the patient with hyperprolactinaemia. Sexual dysfunction is the main signs, including erectile dysfunction in men, amenorrhea in women, and galactorrhea, decreased libido and infertility. Other symptoms include headache and vision loss. Blood hormone test and cranial MRI scan may help find the cause. Treatments of hyperprolactinaemia include observation, medications and surgery. The selection depends on the cause and the size of the tumor. Most hyperprolactinaemia have good outcomes with the treatment of medication.

How do I know if I have hyperprolactinaemia and what are the symptoms of hyperprolactinaemia?
Signs and symptoms result from abnormal secretion of prolactin and the pressure of the tumor in or around the pituitary gland. Usual signs and symptoms include:
 * Headache
 * Vision loss
 * Sexual dysfunction: In men, patients may show signs of decreased libido, erectile dysfunction, and infertility. In women, usual symptoms include decreases in menstruation or amenorrhea, galactorrhea) without pregnant or nursing, loss of libido, intercourse pain and infertility.

Who is at risk for hyperprolactinaemia?

 * Prolactinoma
 * Pituitary tumors
 * Hypothyroidism
 * Sarcoidosis
 * Chronic renal failure
 * Polycystic ovary syndrome
 * Stress
 * Certain medications, including commonly prescribed antidepressants, anti-psychotics, and blood pressure medications.
 * Idiopathic

How to know you have hyperprolactinaemia?

 * Blood hormone test: In patients with hyperprolactinaemia, it may demonstrate elevated prolactin level, low testosterone level and low FSH and LH levels.
 * Cranial MRI or CT scan: In these imaging tests, doctors may detect whether the pituitary tumor exists or not.
 * Visual field examination: For patients with abnormal visual fields, visual field examination by an ophthalmologist is needed.

When to seek urgent medical care?
Call your health care provider if you have any symptoms of hyperprolactinaemia.

Treatment options
Treatment of hyperprolactinaemia depends on the cause of the disease and the size of the tumor.
 * For women who have hyperprolactinemia with no identifiable causes or a small pituitary tumor, the treatment is not surgery and medications, but observation and regular check.
 * Medications: The most common drug for hyperprolactinaemia is dopamine-agonist medications, such as bromocriptine and cabergoline, which can decrease the level of prolactin. The doctor will start you on a low dose and gradually increase the dose until your prolactin levels return to normal. Usual side effects of these drugs include lightheadedness, nausea and headache.
 * Surgery: Surgery is only needed for large pituitary tumors that don't improve with medical treatment.

Diseases with similar symptoms

 * Acromegaly
 * Erectile dysfunction
 * Hypothyroidism
 * Pituitary adenoma
 * Renal function failure

Where to find medical care for hyperprolactinaemia?
Directions to Hospitals Treating hyperprolactinaemia

Prevention of hyperprolactinaemia
Preventive measures are unknown for hyperprolactinaemia.

What to expect (Outook/Prognosis)?
Most hyperprolactinaemia have good outcomes with medication.

Copyleft Sources
http://www.asrm.org/Patients/FactSheets/Prolactin_Excess.pdf

http://www.nlm.nih.gov/medlineplus/ency/article/000337.htm