Hyperprolactinemia

Hyperprolactinemia is the most common pituitary disease, with galactorrhea and hypogonadism as prominent manifestations. Female patients may experience decreased libido and loss of sexual desire, which will be relieved after treatment as PRL levels decrease. Male patients mainly experience decreased libido and impotence, and in severe cases, body hair loss, testicular atrophy, reduced sperm count, and even azoospermia may occur.

Hyperprolactinemia refers to a syndrome caused by internal and external environmental factors, characterized by elevated prolactin (PRL) (>25ng/ml), amenorrhea, galactorrhea, anovulation and infertility. From the perspective of pathological changes, it can be divided into tumor hyperprolactinemia, postpartum hyperprolactinemia, idiopathic hyperprolactinemia and iatrogenic hyperprolactinemia. The main clinical features are amenorrhea, infertility and galactorrhea.

The most prominent manifestation of hyperprolactinemia is hypogonadism, which is caused by elevated PRL levels and is called hyperprolactinemic hypogonadism. Female patients may experience decreased libido and loss of sexual desire, which will be relieved after treatment as PRL levels decrease. In women of childbearing age, hyperprolactinemic hypogonadism is mainly manifested by decreased menstruation or even amenorrhea, but it can also be manifested as menorrhagia or normal menstruation with infertility.

Galactorrhea is another common symptom seen in female patients. Most patients have well-developed breasts, which is in sharp contrast to the breast shrinkage of those who have undergone natural menopause. Spontaneous galactorrhea is rare, and milk can only be seen flowing out by squeezing the nipples. Those with high blood PRL levels do not experience galactorrhea, which may be due to the fact that high PRL strongly inhibits the function of the gonads and significantly reduces the estrogen level. Patients with this disease have true galactorrhea, with fluid flowing out of both nipples. It is a milky or turbid white fluid, rich in casein, whey protein and lactose, and should be differentiated from pseudogalactorrhea.