Hyperprolactinaemia

Who it affects

A high blood prolactin level is detected in less than 1% of the general population.

What gland is involved

Prolactin is released from the pituitary gland, a small gland just below the brain and behind the nose. This hormone may be elevated due to a lesion within the gland itself or due to drugs such as Metoclopramide or anti-psychotic medication. Lesions within the pituitary gland that may associated with hyperprolactinaemia, may be sub-classified into a small benign tumour (microadenoma; <1cm) or a larger benign tumour (macroadenoma; >1cm).

Symptoms

Patients may have no symptoms and the results may be detected coincidently. Symptoms that patients may experience include infrequent or absent menstruation (oligoamenorrhoea), milk production from the breast (galactorrhoea), headaches and visual problems. Men may complain of a reduced libido and erectile problems.

Diagnosis

Hyperprolactinaemia is diagnosed with a blood test. To investigate for an underlying cause, a pituitary CT or MRI scan is performed.

Treatment

In some cases, no treatment is required. In some situations, causative medication may be discontinued and in other cases medication such as Bromocriptine, Cabergoline or Quinagolide are used to control prolactin levels. Pituitary surgery is needed in some cases where vision is disturbed by a large pituitary tumour and medication is ineffective.

Prognosis

The prognosis in this disorder is very good as medical treatment is usually very effective. In a significant number of patients, particularly those with microprolactinomas, medical therapy can be withdrawn successfully. This should only be done under clinical guidance.