Diagnosis and Treatment of Hyperprolactinemia

Abstract

Hyperprolactinemia is a common cause of reproductive problems encountered clinical practice. It is more frequent in women, but also seen in men and even in adolescence and childhood. A variety of pathophysiological conditions can lead to hyperprolactinemia such as pregnancy, drug effects, hypothyroidism and polycystic ovary syndrome. Prolactin is mainly a lactogenic hormone but has other actions. Most cases present with amenorrhea and infertility and are managed by gynecologists. Medical therapy with dopamine agonist is the treatment of choice for both micro- and macroadenomas. Tumor shrinkage and restoration of gonadal function are achieved in the majority of cases with dopamine agonists. However, multidisciplinary involvement may be required in some cases. A trial of withdrwal of medical therapy may be considered in many patients with close follow-up. Evidence relating to etiology, clinical features, pathogenesis and management has been discussed.