Hyperprolactinoma
Hyperprolactinoma is a benign tumor type of pituitary adenoma causes excessive production of prolactin hormone
Prolactin hormone functions
- lactation – milk production
- Breast development
- Reproductive function regulation
Prolactin inhibits GnRH (Gnadotropin releasing hormone) leading to suppression of ovulation - Immune system modulation
- Metabolism
Etiology
- tumurs – prolactin secreting adenoma(macro adenoma,micro adenoma)
- dopamine disruption – normally dopamine inhibits prolactin- medication interference with dopamine.
Antipsychotics- respiridone ,haloperidol.
Antidepressants- tricyclics
CCB- verapamil - Primary hypothyroidsm
- Spinal cord lesions
- pregnancy and lactation
- Stress and sleep
Clinical manifestations
- In women’s
Galactorrhea
Infertility
Loss of Libido
Amenorrhea - In men
Erectile dysfunction
Gynaecomastia
Infertility - others – Headache and vision problem
Diagnosis
- increased prolactin level ( >200 )
- MRI
Management of Hyperprolactinoma
Symptomatic
Dopamine receptors agonist – carbergoline, bromocriptin
if medical management fails
- Trans sphenoidal surgery
- pitutory radiotherapy