What causes hyperprolactinemia?

Prolactin is a polypeptide hormone, also called prolactin, which is one of the hormones secreted by the pituitary gland. The physiological effects of prolactin are extremely extensive and complex. Its main function for women is to maintain lactation and promote gonadal development, so it is also called prolactin. Clinically, it is found that many women with fetal growth retardation and infertility have elevated prolactin levels. Let's take a look at the reasons for this.

①Hypothalamic disorders

Diseases of the hypothalamus and adjacent areas, such as encephalitis, craniopharyngioma, pineal tumor, partial hypothalamic infarction, pseudotumor cerebri, pituitary stalk transection, etc., can cause prolactin to be secreted blindly due to the loss of inhibition, thereby promoting an increase in prolactin.

②Pituitary diseases

It mainly refers to various tumors in the pituitary gland. It is the most common cause of hyperprolactinemia, with pituitary prolactinoma being the most common. About 75% of women with pituitary tumors suffer from hyperprolactinemia.

③Primary hypothyroidism

The thyroid gland and the breast gland, one in the neck and the other in the chest, seem to be two organs that do not interfere with each other, but in fact, the endocrine relationship between the two is very close. Hypothyroidism can also cause excessive secretion of pituitary prolactin.

④Drug factors

Tranquilizers acting on the central nervous system, such as chlorpromazine, morphine, etc.; antihypertensive drugs, such as methyldopa, reserpine, etc.; in addition, metoclopramide and morphine can also stimulate the excessive secretion of pituitary prolactin.

⑤ Nerve stimulation

Certain parts of the skin, especially the chest, are irritated, including severe pain caused by peripheral nerve damage, which can cause increased prolactin levels, such as chest surgery, burns, herpes zoster on the chest and back, etc. In addition, frequent stimulation of the breasts, such as chronic breast abscesses, cystic breast tumors, especially those mothers who let their children suck on their nipples frequently, can also cause endocrine disorders due to long-term stimulation, causing increased prolactin.

⑥Other factors

Patients with adrenal tumors, adrenal adenomas, bronchial lung cancer, severe mental trauma and obvious changes in lifestyle habits may also cause elevated prolactin. Clinically, 30%-40% of patients cannot find any cause, which is collectively referred to as "unexplained galactorrhea" or "idiopathic galactorrhea."

【Extended link】Prolactin test precautions

1. If prolactin is found to be slightly elevated, a blood sample needs to be collected and repeated to clarify the result;

2. The secretion of prolactin (PRL) has a certain rhythmicity, and there are relatively large changes in a day. Its secretion is affected by many factors. Various stress states (such as surgery, trauma, etc.), drugs, exercise, sleep, eating, etc. can affect its secretion. Therefore, it is best to test prolactin in a resting state, with blood drawn between 8 and 10 in the morning, preferably on an empty stomach, and sit quietly for 15-20 minutes before blood collection.