Hyperprolactinemia

I believe that women who are preparing for pregnancy or pregnant are not unfamiliar with prolactin. Have you ever been terrified when you see a high level of prolactin in the sex hormone test report? In this popular science, we should learn a saying: if you are afraid of it, then go and understand it. As the saying goes, knowing yourself and knowing the enemy, you will win every battle! The following editor will popularize the relevant knowledge of hyperprolactinemia for you.

1. What is hyperprolactinemia?

Hyperprolactinemia is caused by various reasons that lead to abnormal increase of serum prolactin (PRL) to greater than 1.14nmol/L (25μg/L). The prevalence rate in the general population is 0.4%, and it can be as high as 9% to 17% in patients with reproductive dysfunction, and it is higher in women than in men.

What causes hyperprolactinemia?

1. Physiological reasons: nighttime and sleep (2 to 6 a.m.); women's late ovulation and luteal phases; pregnancy, lactation, and postpartum period; hypoglycemia; exercise and stress stimulation; sexual intercourse, with a significant increase during orgasm; others: dehydration, stress, and breast stimulation can also cause PRL to increase.

The increase in prolactin caused by the above factors is a normal physiological reaction. It will recover on its own within a short period of time or with the end of pregnancy and lactation, and no treatment is required.

2. Pathological causes:

(1) Hypothalamic diseases: craniopharyngioma, inflammation

(2) Pituitary disease: This is the most common cause of hyperprolactinemia, with pituitary prolactinoma being the most common. When PRL is 60-100 μg/L, long-term follow-up is required. If it is higher than 100 μg/L, CT or MRI may indicate microadenoma. More than one-third of patients have pituitary microadenomas (diameter <1 cm).

(3) Primary hypothyroidism

(4) Idiopathic hyperprolactinemia: serum prolactin is elevated, but no pituitary or central nervous system disease is found. Some patients are found to have pituitary microadenomas several years later.

(5) Others: Polycystic ovary syndrome, long-term use of antipsychotics, antidepressants, anti-epileptic drugs, antihypertensive drugs, anti-gastric ulcer drugs, autoimmune diseases, and trauma can all cause a mild or significant increase in serum prolactin.

(6) Chest diseases: trauma, surgery, burns, herpes zoster.

(7) Gynecological and obstetric surgeries such as artificial abortion, induced labor, stillbirth, hysterectomy, tubal ligation, oophorectomy, etc.

I hope the above introduction to knowledge related to hyperprolactinemia will be helpful to you.