Hyperprolactinemia is a condition where there are high levels of prolactin in the blood. It can be caused by stress, medication, or diseases affecting the hypothalamus, kidneys, liver, ovaries, pituitary gland, or thyroid gland. Symptoms differ between men and women, but can include infertility, loss of libido, and menstrual interruptions. Medications that can cause hyperprolactinemia include minoxidil, cisapride, and antipsychotics.
Hyperprolactinaemia is a medical condition characterized by abnormally high levels of the hormone prolactin in the blood. Prolactin is produced by the anterior pituitary gland and is associated with breastfeeding. Hyperprolactinaemia is normal in pregnant and breastfeeding women. It can also be caused in men and women by stress or insufficient thyroid production, as a pharmaceutical side effect, or as a symptom of diseases affecting the hypothalamus, kidneys, liver, ovaries, pituitary gland, or thyroid gland. Symptoms of hyperprolactinaemia in women include production of breast milk and interruptions of the menstrual cycle, while affected men can experience low testosterone levels, infertility and erectile dysfunction.
Medications that can cause hyperprolactinemia as a side effect include minoxidil for hair loss, cisapride for nausea and acid reflux disease, ramelteon for insomnia, tranquilizers, and antipsychotics. All drugs that decrease the brain chemical dopamine or reduce its effects can cause hyperprolactinemia, because dopamine normally suppresses the secretion of prolactin. Indeed, dopamine antagonists have been used for decades to induce the secretion of breast milk by stimulating the secretion of prolactin.
Hyperprolactinemia can also be caused by diseases that block the flow of dopamine to the anterior pituitary gland, such as tumors near the pituitary gland. Kidney failure and sarcoidosis are other possible causes. Elevated prolactin levels are common following seizures, but not other seizure types, so hyperprolactinemia can be used to diagnose epilepsy. In some cases, elevated prolactin levels occur with no apparent medical cause. Prolactin secretion can be restored to normal levels through dopamine-stimulating drugs or herbal supplements, including bromocriptine, cabergoline, quinagolide, and rose root.
Men and women experience different symptoms of hyperprolactinaemia. In women, the condition causes the production of breast milk, even if the woman is not pregnant. It can also cause low estrogen levels, leading to infertility, menstrual interruptions, loss of libido or sex drive, and vaginal dryness. Menstrual symptoms can take the form of missed periods, irregular bleeding, and even the complete absence of menstrual periods, a condition called amenorrhea.
Men suffering from elevated prolactin levels can experience symptoms including infertility, loss of libido and erectile dysfunction. In rare cases, affected men may also produce breast milk. Often, the symptoms are too mild in men to detect the disorder early. In advanced stages caused by cancer, an enlarged pituitary can cause headaches and vision loss if it puts pressure on the optic nerve. Excessive prolactin levels can lead to osteoporosis in the long term due to decreased estrogen.
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