Causes of Hyperprolactinemia
One common cause of hyperprolactinemia is a growth or tumor on the pituitary gland called a prolactinoma. The tumor produces high levels of prolactin. These tumors can be large or small and are usually benign, meaning they are not cancerous.
Large tumors can also cause headaches, vision problems, or both. Prolactinomas are more common in women than in men and rarely occur in children. Other causes are:
Hypothyroidism or underactive thyroid—meaning the thyroid gland does not produce enough thyroid hormone
Chest-wall injuries or other conditions that affect the chest wall, such as shingles
Other tumors and diseases affecting the pituitary gland, or radiation treatment for tumors on or near the pituitary
Chronic liver and kidney diseases
Certain prescriptions can also increase prolactin levels. These include medicines for:
High blood pressure (such as calcium-channel blockers and methyldopa)
Depression (tricyclic and SSRI antidepressants)
Heartburn and gastroesphageal reflux disease
Nausea and vomiting
Pain (opiates—drugs derived from opium)
Serious mental health disorders (antipsychotics such as risperdal and haloperidol)
Menopausal symptoms (estrogen)
Treatment For Hyperprolactinemia
Treatment is based on the cause. Some people with high prolactin levels, but few or no signs and symptoms, do not need any treatment.
Options for treating tumors include:
Prescription medicines. Bromocriptine and cabergoline decrease prolactin production. Medicines work well for most people with prolactinomas.
Surgery to remove a tumor. Surgery may be used if medicines have not been effective. Surgery is sometimes needed if the tumor is affecting vision.
Radiation. Rarely, if medicines and surgery have not been effective, radiation is used to shrink the tumor.
Hypothyroidism can be treated with synthetic thyroid hormone, which should bring prolactin levels down.
If high prolactin levels are caused by prescription drugs, substitute medications may be prescribed.
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