Klinik Temasya
Primary Care Medicine

Hyperprolactinaemia

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Hyperprolactinaemia is a hormonal disorder cause by excessive level of prolactin hormone in the body. 

Prolactin is a hormone produced by a structure called pituitary in your brain. It stimulates breast tissue and induces milk production. Physiologically, prolactin level can be high during pregnancy, lactation, nipple and chest wall stimulation, stress and during sleep.

Other abnormal causes of high prolactin includes pituitary adenoma (cancer of pituitary gland and most common cause), other cancers that can damage hypothalamus-pituitary stalk such as craniopharyngioma and meningioma, infections (such as tuberculosis), head injury, acromegaly, certain medications and systemic disorders such as kidney or liver failure. 

Excessive prolactin in women cause cause many issues like infertility, abnormal menstrual patterns in female (light, irregular or absence menses), decrease sex drive, pain at the breast area and milk produced from the breast not related to pregnancy or post-natal (galactorrhoea), decrease bone mass leading to fracture and vaginal dryness.

In men, it cause breast enlargement ('gynaecomastia'), milk production from the breast, sexual disorders like erectile dysfunction and loss of libido. 

If the pituitary adenoma is large enough, it can cause local pressure symptoms such as headache and blurring of vision. 

The normal serum prolactin levels vary between 5 and 25 ng/ml although and its best measured in the morning while fasting. Hyperprolactinemia is usually defined as fasting levels of above 20 ng/ml in men and above 25 ng/ml in women at least 2 hours after waking up. 

Pituitary adenoma is diagnosed by imaging such as CT or MRI brain. The management is depends on the size of the adenoma. Small adenoma (microadenoma) can be treated with medication such as Bromocriptine and minimally invasive surgery and larger adenoma (macroadenoma) may require either medication, surgery or radiation.

If you have any of the the above symptoms and concern about hyperprolactinaemia, talk to a doctor and get your hormone level test today. 

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