Scientific Diagnosis of Hyperprolactinemia

What are the scientific diagnoses for hyperprolactinemia? In fact, for patients with hyperprolactinemia, doctors need to do a physical examination, because in certain circumstances, only after we have done a physical examination of hyperprolactinemia can we timely understand the pain that hyperprolactinemia brings to patients. For this reason, the following summary is made for the knowledge of disease diagnosis of hyperprolactinemia.

1. Medical history: Focus on understanding menstrual history, marital history, the cause and triggers of amenorrhea and galactorrhea, systemic diseases and the history of drug treatment related to HPRL.

2. Physical examination: A full-body physical examination, paying attention to the presence of acromegaly, myxedema and other symptoms. A gynecological examination to understand whether the genitals and sexual characteristics are atrophic or have organic lesions. A breast examination pays attention to size, shape, lumps, inflammatory galactorrhea (gently squeeze the breasts with both hands), and the nature and amount of the discharge.

3. Endocrine function examination: Pituitary function: FSH, LH decreased, LH/FSH ratio increased, PRL increased ≥ 25ng/ml. It is generally believed that <100ng/ml is mostly functional, and ≥100mg/ml should be careful to exclude PRL adenoma. The larger the tumor, the higher the PRL. For example, if the tumor diameter d≤5mm, PRL is 171±38ng/ml; d=5～10mm206±29ng/ml; ≥10mm485±158ng/ml. When giant adenoma is hemorrhagic and necrotic, PRL may not increase.

It should be pointed out that the PRL radiotherapy kit currently used in clinical practice can only measure small molecule PRL (MW 25000), but cannot measure large/large molecule (MW 5-100000) PRL. Therefore, for some patients with obvious clinical symptoms but normal PRL, the so-called occult hyperprolactinemia (occult hyperprolactinemia), that is, large/large molecule hyperprolactinemia, cannot be ruled out.

The above experts have summarized the three aspects of hyperprolactinemia diagnosis. However, in certain circumstances, we also need patients to cooperate with treatment and management when caring for hyperprolactinemia. For example, we should promptly understand the healthy diet knowledge of hyperprolactinemia and tell patients that they should be re-examined after a period of treatment.