Hyperprolactinemia is characterized by an increase in the level of prolactin in the blood. This hormone is responsible for stimulating breast growth during pregnancy and milk production after childbirth.
Inadequate secretion of prolactin in women can lead to ovulation disorders, menstrual cycle disturbances, infertility, and the production of breast milk unrelated to breastfeeding or galactorrhea.
Knowing the causes of hyperprolactinemia is essential when selecting a treatment to achieve pregnancy with the least amount of stress. Usually, oral medications such as bromocriptine are used. If these are not enough, the best option is in vitro fertilization (IVF).
Hyperprolactinemia is characterized by an increase in the level of prolactin in the blood of a woman who is not pregnant or breastfeeding.
Prolactin is a hormone secreted by the pituitary gland, and its main functions are to stimulate breast growth during pregnancy and milk production after childbirth.
Inadequate secretion of prolactin in women can lead to ovulation disorders, menstrual cycle disturbances, infertility, and breast milk production unrelated to breastfeeding or galactorrhea.
Amenorrhea or absence of menstruation and galactorrhea or production of breast milk unrelated to breastfeeding are the main clinical manifestations of hyperprolactinemia, and 75% of patients with both symptoms suffer from this condition.
Other symptoms of hyperprolactinemia include:
Hyperprolactinemia can be caused by various factors:
If you suffer from menstrual irregularities, galactorrhea, or any of the symptoms of hyperprolactinemia, it is recommended that:
You should have a blood test to determine your prolactin level if you have menstrual irregularities, galactorrhea, or any other symptoms of hyperprolactinemia. The test should be performed in the early morning after at least thirty minutes of rest, but it can be done at any point in the menstrual cycle.
If the first test shows elevated levels, it should be repeated to confirm the diagnosis of hyperprolactinemia.
When prolactin levels are still high after the second test, the first causes to be ruled out before undertaking further studies are pregnancy and the use of medications that increase prolactin secretion. Your doctor will also conduct tests to rule out conditions such as hypothyroidism, in which excess prolactin is produced to compensate for the malfunctioning of the thyroid and the resulting lack of thyroid hormone.
Finally, once all other possible causes have been excluded, you will need to undergo magnetic resonance imaging or computed tomography to rule out the presence of a pituitary tumor or adenoma.
Understanding the causes of hyperprolactinemia is essential when selecting a treatment that allows pregnancy to be achieved with minimal wear and tear. Currently, highly effective solutions exist for each of these causes.
If your high prolactin level is caused by medication, your doctor will ask you to discontinue its use and help you find other options. If you have hypothyroidism, your doctor should prescribe a synthetic thyroid hormone to normalize your prolactin levels.
In any other case, treatment of hyperprolactinemia should begin with oral medications such as bromocriptine and cabergoline. Your doctor will ask you to take a low dose and gradually increase it until your prolactin level returns to normal. The use of medication has a very favorable prognosis, as it not only reduces prolactin levels and pituitary tumors, but also remedies galactorrhea by resuming menstruation and fertility in a short time.
If medication is not enough, the best option is in vitro fertilization (IVF), which makes it possible to aspirate eggs directly from the ovaries for subsequent fertilization and implantation in the woman's uterus.
In a small number of cases where prolactin increase is caused by pituitary tumors larger than 10 millimeters that do not improve with medication, the possibility of surgery or radiation therapy should be evaluated.
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