Hyperprolactinemia

Hyperprolactinemia is an endocrine disorder characterized by elevated levels of prolactin, a hormone produced by the pituitary gland that primarily regulates lactation. While prolactin is essential during pregnancy and breastfeeding, excessive levels outside these conditions can disrupt normal reproductive and hormonal balance. This condition commonly affects women but can also occur in men.

The most frequent cause is a benign pituitary tumor called a prolactinoma. Other causes include hypothyroidism, chronic stress, certain medications (such as antipsychotics and antidepressants), and systemic illnesses. Elevated prolactin interferes with the secretion of gonadotropin-releasing hormone (GnRH), leading to reduced levels of estrogen or testosterone.

In women, symptoms may include irregular or absent menstrual cycles, infertility, galactorrhea (unexpected milk production), and decreased libido. Men may experience erectile dysfunction, reduced libido, infertility, and sometimes breast enlargement. In severe cases, large tumors can cause headaches and vision disturbances due to pressure on surrounding structures.

Diagnosis involves blood tests to measure prolactin levels and imaging studies like MRI to identify pituitary abnormalities. Treatment depends on the cause and may include dopamine agonists to lower prolactin levels, thyroid hormone therapy, or surgical intervention if required.