Hyperprolactinemia

Hyperprolactinemia, a condition caused by elevated levels of the hormone prolactin in the body, can lead to symptoms such as irregular menstrual cycles or amenorrhea (absence of menstruation), infertility, or milk production from the breasts without pregnancy. Prolactin, known as the milk hormone, is essential for the development and function of female reproductive organs and should generally be below 25 ng/ml in a healthy woman. Levels above this can cause decreased or absent menstruation, and inability to conceive even when trying to conceive using contraception.

Causes of Hyperprolactinemia

Some of the causes that lead to elevated levels of the prolactin hormone, which causes hyperprolactinemia, are as follows:

• Pregnancy and breastfeeding periods
• Tumors and injuries that reduce dopamine release from the hypothalamus.
• Estrogen-containing birth control pills
• Benign tumors such as prolactinomas
• Hypothyroidism, elevated TRH hormone levels.
• Some of the medications used in psychiatry (antidepressants and antipsychotics)
• Other pharmacological drugs (especially metpamide-derived antiemetics - i.e., anti-nausea drugs)
• To have an orgasm
• Excessive stress
• Kidney failure
• Liver cirrhosis

Symptoms of Hyperprolactinemia

The presence of hyperprolactinemia can lead to various symptoms in the body. Irregular menstrual bleeding or changes in ovulation, headaches, fatigue, loss of appetite, low energy, and depression are symptoms that may indicate elevated prolactin levels. In addition, impaired or blurred vision, osteoporosis, decreased libido, vaginal dryness, dyspareunia (painful intercourse) due to vaginal dryness, infertility, galactorrhea, and weight gain are also among the symptoms of hyperprolactinemia.

Diagnosis and Treatment of Hyperprolactinemia

Patients presenting with the symptoms listed above undergo a blood test for prolactin hormone. This test examines the patient's prolactin hormone level and determines how much higher than normal it is. Ideally, the test should be performed during the menstrual period. However, the patient is asked to have the test done in the morning, to stop sexual intercourse 2-3 days before the test, and to avoid breast stimulation. If the test result shows a high hormone level, the patient undergoes advanced imaging techniques such as pituitary X-ray (cella spot X-ray), pituitary CT (computed tomography), or MRI (magnetic resonance imaging) to show the pituitary gland.

Treatment for hyperlactinemia is planned according to the cause of the elevated prolactin level. Treatment usually involves medications that lower prolactin levels, but surgical treatment may be considered for very large lesions.