Hyperprolacteniemia

Hyperprolacteniemia
• HP is the commonest cause of amenorrhea ( pituitary cause ) .
• Prolactin is a hormone secreted from lactotrophes cells of anterior pituitary gland , its function is for synthesis and production of milk from the glandular tissue of the breast.
• It is inhibited by dopamine & dopamine agonist which act on hypothalamus.
• The normal level of prolactin is < 400 mu/L

• Causes of hyperprolactinemia:
? Physiological :
1- Pregnancy
2- Lactation
3- Breast examination
4- Venipuncture
5- Sleep
6- Stress

? Pathological :
1- Idiopathic
2- Pituitary adenoma ( microadenoma < 10 mm , macroadenoma > 10 mm which serum level reach > 8000 mu/L)
3- Non-functional pituitary or hypothalamic tumor in which serum prolactin my reach > 3000 mu/L
4- Renal failure
5- Hypothyroidism
6- PCOS
7- Drugs like :
a. Metoclopramide
b. Phenothiazine
c. Omeprazole
d. Methyldopa
e. Reserpine
Clinical Features:
The patient presented with different signs & symptoms :
- Less than 50 % has galactorrhea ( milk or breast discharge ) .
- Headache
- Visual disturbance due to pressure or compression of optic chiasma
- Sign of hypoestrogenemia as prolactin inhibit the release of estrogen , other sign include oligomenorrhea , amenorrhea , primary or secondary infertility , while patient with PCOS may have hyperprolactinemia with normal estrogen & withdrawal bleeding when giving progesterone ..