Choice of different treatments for hyperprolactinemia

The choice of different treatment methods for hyperprolactinemia. Prolactin is a polypeptide hormone, also called prolactin (PRL), which is one of the hormones secreted by the pituitary gland. Under normal circumstances, the content of prolactin in the body has a certain standard. If it exceeds this standard, hyperprolactinemia will form, which will endanger women's health. There are many reasons for the secretion of prolactin. Before treatment, everyone must find the cause and treat it symptomatically.

What are the causes of elevated prolactin?

Drug factors: Sedatives that act on the central nervous system, such as chlorpromazine and morphine, can reduce the content of catecholamines in the hypothalamus, thereby reducing the activity of prolactin-releasing factor produced by the hypothalamus; antihypertensive drugs such as methyldopa and reserpine can inhibit the release of prolactin-inhibiting factor; metoclopramide can stimulate excessive secretion of pituitary prolactin.

Pituitary disorders are mainly various tumors in the pituitary gland. In addition, some empty sella syndrome and hyperpituitarism can also cause galactorrhea and amenorrhea.

Hypothalamic disorders Diseases of the hypothalamus and adjacent parts, such as encephalitis, craniopharyngeal tumor, pineal tumor, partial hypothalamic infarction, pseudotumor cerebri, pituitary stalk severance, etc., can all cause a decrease in prolactin-inhibiting factor produced by the hypothalamus, or an increase in prolactin-releasing factor and thyrotropin-releasing factor. The former can cause prolactin to be produced blindly due to the loss of inhibition, while the latter two directly promote the increase of prolactin production.

Primary hypothyroidism When the thyroid function is hypofunctioning, the information of insufficient thyroid secretion is transmitted to the hypothalamus in feedback, causing the hypothalamus to produce a large amount of thyrotropin-releasing factor. This factor can stimulate the pituitary gland to secrete thyroid stimulating hormone while stimulating the excessive secretion of pituitary prolactin, causing galactorrhea. Primary hypothyroidism When the thyroid function is hypofunctioning, the information of insufficient thyroid secretion is transmitted to the hypothalamus in feedback, causing the hypothalamus to produce a large amount of thyrotropin-releasing factor. This factor can stimulate the pituitary gland to secrete thyroid stimulating hormone while stimulating the excessive secretion of pituitary prolactin, causing galactorrhea.

Nerve stimulation: Irritation of certain parts of the skin, especially the chest, including severe pain caused by peripheral nerve damage, can be transmitted to the hypothalamus through nerves and cause an increase in prolactin, such as chest surgery, burns, herpes zoster on the chest and back, etc.

How to treat high prolactin?

Bromocriptine is the first choice for inhibiting the secretion of prolactin. This drug can inhibit the synthesis and secretion of prolactin, control the growth of pituitary microadenomas, and even significantly reduce the tumor. The common side effects of bromocriptine are nausea, headache, fatigue, and constipation. Therefore, it is necessary to take the drug under the guidance of a doctor. Data show that prolactin can be significantly reduced after one week of medication, galactorrhea stops after 2-4 weeks of medication, and menstruation resumes. Ovulation and pregnancy can occur after 3-6 months of medication.

Etiological treatment means taking different treatment methods for different causes. If it is caused by drugs, the drugs should be stopped first. If it is caused by hypothyroidism, thyroxine tablets can be taken for replacement therapy. If it is a pituitary tumor, it can be treated with drugs or surgery depending on the size of the tumor.

Combined treatment: Patients with hyperprolactinemia who want to have children can be treated with bromocriptine first. If ovulation still cannot be restored, ovulation-inducing drugs can be added.