What are the routine examination items for hyperprolactinemia?

Hyperprolactinemia is a very common disease among women of childbearing age. It can cause women to have irregular menstruation, amenorrhea, galactorrhea and other problems. The continuous increase in the high lactation blood value will affect the production and discharge of eggs, and eventually lead to infertility, which needs to be taken seriously. So what tests should be done when hyperprolactinemia occurs?

Endocrine hormone measurement: follicle stimulating hormone (FSH) and luteinizing hormone (LH) decreased, and the LH/FSH ratio increased. If prolactin (PRL) ≤ 100ng/ml, it is mostly functional increase, and PRL ≥ 100ng/ml is mostly tumor increase. The larger the tumor, the higher the PRL. For example, if the tumor diameter is ≤ 5mm, the PRL is (171±38)ng/ml; if the tumor diameter is 5-10mm, the PRL is (206±29)ng/ml; if the tumor diameter is ≥ 10mm, the PRL is mostly (485±158)ng/ml. Plasma PRL may not increase when giant adenoma is hemorrhagic and necrotic.

Thyroid, adrenal and pancreatic function tests: When hyperprolactinemia is combined with hypothyroidism, thyroid stimulating hormone (TSH) is elevated, and T3, T4, and PBI are decreased. When hyperprolactinemia is combined with Cushing's disease and virilization symptoms, testosterone (T), androstenedione (△4dione), dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), 17-ketosteroids (17KS) and plasma corticosteroids are elevated. When hyperprolactinemia is combined with diabetes and acromegaly, plasma pancreatic insulin, blood sugar, glucagon and a glucose tolerance test should be measured. This test can identify the cause of hyperprolactinemia accordingly.

Prolactin stimulation test: It is mainly used to observe the changes of prolactin. However, when the prolactin level is high, its identification value is small.

Prolactin suppression test: mainly includes levodopa test and bromocriptine test.

Other examinations: Pituitary CT, MRI examinations and blood prolactin determination are of great significance for etiology diagnosis.

Through the detailed introduction of experts, I believe everyone knows the examination items that need to be done for hyperprolactinemia. If you find that your menstrual flow has decreased or amenorrhea occurs, you should go to a professional hospital as soon as possible for careful examination and treatment to prevent it from affecting your life and work. Of course, the above examination items do not necessarily have to be done in full, and the examination should be done according to the doctor's arrangement.