Causes of 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.

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, no cause can be found in 30% to 40% of patients, which is collectively referred to as "unexplained galactorrhea" or "idiopathic galactorrhea."