Early symptoms of hyperprolactinemia

Hyperprolactinemia, if it is pathological, will have other clinical manifestations in addition to the physiological increase in milk. To understand the disease, you have to understand its symptoms. The following is an introduction to the symptoms of the disease, I hope you can read it carefully.

1. General manifestations

(1) Menstrual disorders: Primary amenorrhea accounts for 4%, secondary amenorrhea accounts for 89%, oligomenorrhea accounts for 7%, and dysfunctional bleeding and luteal insufficiency account for 23% to 77%.

(2) Galactorrhea The incidence of typical amenorrhea-galactorrhea syndrome in non-tumor hyperprolactinemia is 20.84%, in tumor-type hyperprolactinemia is 70.6%, and in simple galactorrhea is 63-83.5%. Galactorrhea is overt or occurs when the breast is squeezed, and is watery, serous, or milky. The breasts are usually normal.

(3) The incidence of infertility is 70.7%, which can be primary or secondary infertility and is related to anovulation, luteal insufficiency or luteinized unruptured follicle syndrome (LUFS).

(4) Hypoestrogenemia and hyperandrogenism: Decreased estrogen levels cause hot flashes, palpitations, spontaneous sweating, vaginal dryness, dyspareunia, decreased libido, etc. Increased androgen levels cause moderate obesity, seborrheic dermatitis, acne, and hirsutism.

(5) Changes in vision and visual field: When pituitary tumors involve the optic chiasm, they can cause decreased vision, headaches, dizziness, hemianopsia and blindness, as well as functional impairment of cranial nerves II, III and IV, and fundus edema and exudation.

(6) Acromegaly: seen in PRL-GH adenoma, myxedema seen in combined hypothyroidism, some patients have type 2 diabetes and osteoporosis.

2. Clinical classification

(1) Tumor-type hyperprolactinemia: accounts for 71.61% of hyperprolactinemia, of which prolactin adenomas account for 46%, microadenomas account for 66%, and macroadenomas account for 34%. A small number of them are prolactin-growth hormone adenomas and chromosomal cell tumors. Most pituitary adenomas have PRL ≥ 200ng/ml, and some pituitary adenomas can regress naturally.

(2) Postpartum hyperprolactinemia: It accounts for 30% of hyperprolactinemia and occurs within 3 years after pregnancy, delivery, miscarriage, or induced labor. Plasma prolactin is slightly elevated, and patients have oligomenorrhea, menstrual disorders, and galactorrhea. The prognosis is good after treatment.

(3) Idiopathic hyperprolactinemia: rare, mostly related to psychological trauma and stress factors, and some are very small adenomas

(4) Iatrogenic hyperprolactinemia is caused by iatrogenic factors or drugs, mostly due to other diseases (such as hypothyroidism), and can recover naturally after the cause is eliminated.

(5) Latent hyperprolactinemia (OHP) is also called latent hyperprolactinemia.