How to check for hyperprolactinemia

Hyperprolactinemia is the most common pituitary disease, with galactorrhea and hypogonadism as prominent manifestations. Female patients may experience decreased libido and loss of sexual desire, which will be relieved after treatment as PRL levels decrease. Male patients mainly experience decreased libido and impotence, and in severe cases, body hair loss, testicular atrophy, reduced sperm count, and even azoospermia may occur.

1. Laboratory test for prolactin measurement: Take blood on an empty stomach 1-2 hours after getting up in the morning to measure PRL. The normal value of PRL on an empty stomach is 0.23-1.14nmol/L (5-25ng/ml). Women have higher levels than men. PRL has a peak secretion related to sleep, usually 1-2 hours after falling asleep. Pregnant women's PRL can increase 10 times, and the baby's sucking can cause an acute increase in PRL, which returns to normal after 2-3 hours. 4-6 weeks after delivery, PRL returns to pre-pregnancy levels. Prolactin>9.1nmol/L (200ng/L) is seen in prolactinoma and chronic renal failure. Other causes of hyperprolactinemia include postpartum lactation, functional hyperprolactinemia, hypothalamic lesions such as sarcoma, histiocytosis, parasellar tumors, pituitary stalk lesions and some drugs that reduce dopamine production, including methyldopa, reserpine, tricyclic antidepressants, phenothiazines, etc. Metoclopramide increases prolactin to 4.5-6.8nmol/L (100-150ng/ml). Prolactin levels may also increase in people with primary hypothyroidism, chest wall diseases and spinal cord lesions.

2. Other auxiliary examinations (1) In children, due to TSH and GH deficiency, bone X-rays may show decreased bone age. (2) CT and MRI examinations are of great significance for diagnosis. These two examinations can show the location, size, cystic changes, invasion of adjacent brain tissues by the tumor, and whether hydrocephalus exists.