Principles of treatment of idiopathic hyperprolactinemia

Idiopathic hyperprolactinemia refers to elevated serum PRL (usually <4.45 nmol/l), negative pituitary, central nervous and systemic examinations, and accompanied by symptoms such as lactation, oligomenorrhea, and amenorrhea.

Cause of idiopathic hyperprolactinemia: The onset of the disease may be related to the heteromorphic structure of the PRL molecule. There are large PRL molecules (molecular weight 40-60KDa, formed by glycosylated PRL dimers and trimers) and large PRL molecules (formed by the polymerization of PRL and immunoglobulin, with a molecular weight greater than 100KDa) in the blood circulation. Both of these PRL macromolecules cannot bind to target cell receptors through the capillary wall and have no biological effect in the body, but their long half-life makes them easily accumulated in the circulation, leading to an increase in PRL measured by immune activity.

Idiopathic hyperprolactinemia is self-limited.

Hyperprolactinemia is still mainly treated with drugs, supplemented by surgery and radiotherapy. Treatment is selected based on individual principles such as the serum PRL level of pathological hyperprolactinemia, clinical symptoms, and whether or not there is a desire to have children. The treatment principles for idiopathic hyperprolactinemia are as follows:

Principles of treatment of idiopathic hyperprolactinemia (I) Treatment of primary disease

Ectopic prolactin secretion caused by ectopic pregnancy, malignant tumors, hypothyroidism, renal failure, etc. requires treatment targeted at the primary disease.

Treatment principles for idiopathic hyperprolactinemia (II) Follow-up observation

If PRL is slightly elevated, menstruation is regular, and the woman does not want to have children, she can be observed for a while.

Principles of treatment of idiopathic hyperprolactinemia (III) Drug treatment of choice

Indications for idiopathic hyperprolactinemia: amenorrhea, low estrogen status, infertility, pituitary microadenoma, or headache, etc.

Treatment options for idiopathic hyperprolactinemia

Bromocriptine (BCT) 2.5 mg, 1-2 times/do, 3 months as a course of treatment. If the PRL level cannot be reduced to normal after taking the medicine for about one week, the dose can be increased to 7.510 mg per day. (High doses should be given 2-3 times a day)

The above is the relevant information about the treatment principles of idiopathic hyperprolactinemia. I hope you will understand it after reading the above introduction.