Hyperprolactinemia

Hyperprolactinemia is an elevation of prolactin, a hormone made by the pituitary gland. The most common cause is a benign pituitary tumor called a prolactinoma. Most cases respond well to medication.

Table of Contents

Quick Facts

  • ICD-10: E22.1
  • Common cause: Prolactinoma
  • Often treated with: Cabergoline or bromocriptine

Symptoms

Women

  • Irregular or absent menstrual periods
  • Milky nipple discharge (galactorrhea)
  • Infertility
  • Reduced libido

Men

  • Erectile dysfunction
  • Reduced libido
  • Infertility
  • Breast tenderness or enlargement

Both

  • Headaches or vision changes (with large tumors)
  • Bone loss with long-standing untreated disease

Causes

  • Prolactinoma (most common pathologic cause)
  • Medications (antipsychotics, some antidepressants, opioids, metoclopramide)
  • Hypothyroidism
  • Kidney or liver disease
  • Pregnancy and breastfeeding (normal)
  • Stress and exercise (mild transient elevation)

Diagnosis

  • Fasting morning prolactin level
  • Thyroid function tests
  • Pregnancy test (women)
  • MRI of the pituitary if persistent elevation

Treatment

  • Dopamine agonists (cabergoline, bromocriptine) — first-line
  • Stop or change causative medications when possible
  • Treat hypothyroidism if present
  • Surgery for tumors not responding to medication
  • Radiation therapy in selected cases

Related Conditions

Hypothyroidism

Can cause hyperprolactinemia

 Infertility

Common feature
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • Endocrine Society. Hyperprolactinemia Guidelines.