Prolactin - Conditions Associated With Elevated Prolactin Secretion

Conditions Associated With Elevated Prolactin Secretion

Hyperprolactinaemia, or excess serum prolactin, is associated with hypoestrogenism, anovulatory infertility, oligomenorrhoea, amenorrhoea, unexpected lactation, and loss of libido in women, and erectile dysfunction and loss of libido in men.

Etiology of hyperprolactinemia:

1. PHYSIOLOGICAL

  • Coitus
  • Exercise
  • Lactation
  • Pregnancy
  • Sleep
  • Stress

2. PHARMACOLOGICAL

  • Anesthetics
  • Anticonvulsant
  • Antihistamines (H2)
  • Antihypertensives
  • Cholinergic agonist
  • Drug-induced hypersecretion
  • Catecholamine depletor
  • Dopamine receptor blockers
  • Dopamine synthesis inhibitor
  • Estogens: oral contraceptives; oral contraceptive withdrawal
  • Neuroleptics/antypsychotics
  • Neuropeptides
  • Opiates and opiate antagonists

3. PATHOLOGICAL

  • Hypothalamic-pituitary stalk damage

– Granulomas - Infiltrations - Irradiation - Rathke's cyst - Trauma: pituitray stalk section, suprasellar surgery - Tumors: craniopharingioma, germinoma, hypothalamic metastases, meningioma, suprasellar pituitary mass extension

  • Pituitary

- Acromegaly - Idiopathic - Lymphocytic hypophysitis or parasellar mass - Macroadenoma (compressive) - Macroprolactinemia - Plurihumoral adenoma - Prolactinoma - Surgery - Trauma

  • Systemic disorders

- Chest-neurologic chest wall trauma, surgery, herpes zoster - Chronic renal failure - Cirrhosis - Cranial radiation - Epileptic seizures - Polycystic ovarian disease - Pseudocyesis

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