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Understanding Hyperprolactinemia with Footsteps To Fertility Centre

Hyperprolactinemia is a condition in which a person has higher-than-normal levels of the hormone prolactin in the blood.

The main function of prolactin is to stimulate breast milk production after childbirth, so high prolactin levels are normal in pregnancy.

 

Prolactin also affects the levels of sex hormones (estrogen and testosterone) in both women and men resulting in irregular menstrual periods and erectile dysfunction, among other things.

Prolactin is made by the pituitary gland, a pea-sized organ found at the base of the brain. At Footsteps To Fertility Centre in Nairobi, Kenya you can expect a peace of mind that you are getting assistance from doctors who are experts in the field and have achieved the highest level of fertility training.

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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)

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Symptoms of Hyperprolactinemia

Both men and women may have infertility, decreased sex drive, and bone loss.

Women may also have:

  • Vaginal dryness, leading to pain during intercourse

  • Problems with menstruation—having no periods or irregular periods

  • Production of breast milk when not pregnant or nursing

Men may also have:

  • Erectile dysfunction—trouble getting or keeping an erection

  • Breast enlargement, called gynecomastia

  • Decreased muscle mass and body hair

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Diagnosis of Hyperprolactinemia

The diagnosis of hyperprolactinemia involves a routine blood test to check prolactin levels.

If the blood levels are elevated, the doctor may want to repeat the test, this time after fasting for at least eight hours. Normal prolactin levels are less than 500 mIU/L for women and less than 450 mIU/L for men

A magnetic resonance imaging (MRI) scan may be ordered to look for evidence of a pituitary growth or for damage to surrounding tissues.

Blood tests to evaluate other hormone levels may be useful in ruling out any other possible causes of the symptoms.

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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