Hyperprolactinemia: Specialists and information

Hyperprolactinemia is an excess of the hormone prolactin in the blood. It is responsible for breast growth during pregnancy and also plays a role in milk production during breastfeeding. During these times, the prolactin level is elevated and thus also suppresses ovulation. However, a pathological increase in the concentration of prolactin in the blood can also occur outside of pregnancy. Men can also be affected. In women, hyperprolactinemia often leads to cycle disorders, the absence of periods and a milk-like secretion from the breast. In men, the glandular tissue of the breast grows and libido decreases. Ultimately, hyperprolactinemia can also lead to infertility in men.

Below you will find more information and selected hyperprolactinemia specialists.

Symptoms of hyperprolactinemia

Typical signs in men are

• Potency problems,
• reduced libido,
• enlargement of the mammary glands and
• Reduction in pubic hair and beard growth.

In women, hyperprolatinemia usually manifests itself through these signs:

• Cycle and sexual disorders,
• Milk production of the mammary glands without pregnancy,
• Androgenization ("masculinization") due to the altered hormone levels: increased body hair, deeper voice, unclean skin due to increased sebum production.

Infertility is also one of the possible consequences of hyperprolactinemia. In men, for example, excess prolactin reduces sperm production. However, those affected cannot diagnose infertility themselves. A fertility test is necessary for this.

In order to recognize and treat hyperprolactinaemia, people need to monitor themselves closely. If they notice any changes in their body or sexual behavior, they should consult a doctor.

Causes of excess prolactin

There are many different causes that can lead to hyperprolactinemia.

One cause can be a benign tumor(pituitary adenoma: prolactinoma). Prolactin is produced in the anterior lobe of the pituitary gland (hypophysis). If a benign tumor develops in the pituitary gland, this can lead to overproduction and increased secretion of the hormone.

Medication can often also increase prolactin production. Some medications influence the effect of the signaling substance dopamine, which acts as a prolactin regulator. These include certain

• neuroleptics,
• antidepressants,
• oestrogen,
• certain antihypertensive drugs,
• painkillers with morphine-like ingredients and
• anti-seizure medication from the group of dopamine antagonists.

The pituitary gland produces and regulates the hormone prolactin. Disorders can lead to an excess of prolactin © bilderzwerg | AdobeStock

In rare cases, an accident or fall can also be the cause of hyperprolactinemia. An injury can damage or tear off the pituitary stalk. Dopamine can then no longer reach the pituitary gland and prolactin production is disrupted.

Also

• an underactive thyroid gland,
• an underactive kidney or
• liver weakness

can also cause hyperprolactinemia.

Diagnosis of hyperprolactinemia

If hyperprolactinemia is suspected, the hormone levels in the blood are determined. If the prolactin levels are elevated, hyperprolactinemia is present. The cause of the elevated values must then be clarified.

With the help of magnetic resonance imaging(MRI), the doctors check whether

• a tumor in the anterior lobe of the pituitary gland or
• a change in the pituitary stalk

is present. Corresponding tests of the

• kidney,
• liver and
• thyroid gland

can reveal a malfunction in these organs.

The doctor can identify drug-related causes from the patient's medical records.

Treating hyperprolactinemia

Once the cause of hyperprolactinemia has been identified, doctors can treat it specifically.

If a certain medication is causing the hyperprolactinemia, its dose should be reduced. Alternatively, a substitute drug may be available.

In the case of a prolactinoma

• Radiotherapy,
• medication or
• surgical intervention

can be considered.

All of these methods have advantages and disadvantages and the approach depends on the individual case. Larger tumors that are already pressing on the optic nerve are usually removed surgically. Smaller prolactinomas, on the other hand, can be treated with medication or radiotherapy.