Can hyperprolactinemia be cured by Western medicine?

Hyperprolactinemia has a great impact on women's future menstruation and pregnancy, but it does not mean that it cannot be cured. Generally, before treatment, a good analysis of the condition should be done and then treatment should be carried out according to different causes. If it is caused by medication, stop taking the medication. If it is caused by hypothyroidism, take thyroxine tablets for replacement therapy. If it is caused by pituitary tumors, drugs and surgery should be used to treat the tumor.

1. Treatment of the cause and primary disease

For example, eliminate adverse mental stimulation, stop taking HPRL-inducing drugs, and actively treat primary diseases such as pituitary tumors, hypothyroidism, Cushing's disease, etc.

2. Anti-prolactin-bromocriptine therapy

Bromocriptine is a semi-synthetic ergot alkaloid derivative and a dopamine receptor agonist. It can promote the synthesis and secretion of PRL-IH and inhibit the synthesis and release of PRL through the receptor mechanism. It also directly acts on pituitary tumors and PRL cells to curb tumor growth and inhibit the secretion of PRL, GH, TSH and ACTH.

Bromocriptine therapy is suitable for all types of HPRL and is also the first choice for pituitary adenomas (micro/macroadenomas), especially for young infertile women who are looking forward to having children. The dose is 2.5-7.5 mg/d, taken orally. Other anti-prolactin drugs include: levodopa, octahydrobenzoquinoline (cv205-502), vitamin b6, etc. For details, please refer to the anti-prolactin section of the endocrine therapy chapter.

3. Ovulation induction treatment

It is suitable for patients with HPRL, anovulatory infertility, and those who cannot successfully ovulate and become pregnant after simple bromocriptine treatment. That is, a comprehensive therapy with bromocriptine as the main drug and other ovulation-promoting drugs: ① bromocriptine-cc-hcg; ② bromocriptine-hmg-hcg; ③ gNRH. Pulse therapy-bromocriptine, etc. Comprehensive therapy can save anti-prolactin, shorten the treatment cycle and increase the ovulation rate and pregnancy rate.

4. Surgical treatment

It is suitable for patients with giant adenomas that present compression symptoms, as well as patients with drug-resistant tumors, patients who are ineffective in bromocriptine treatment, and patients with multiple pituitary hormone secretion in sphenoid cell tumors. The current transsphenoidal microsurgery is safe, convenient, and easy to perform, and its efficacy is similar to that of bromocriptine therapy. The combination of bromocriptine before and after surgery can improve the efficacy. The disadvantages of the surgery are: for patients with pituitary tumors without obvious capsules and unclear boundaries, the surgery is not easy to be thorough or may cause damage, resulting in cerebrospinal fluid nasal fistula and secondary hypopituitarism.

5. Radiation therapy

It is suitable for non-functional tumors of the HP system and those who have not responded to drug and surgical treatment. Irradiation methods include: deep X-ray, 60Co, α particles and proton rays. Isotope 90yttrium, 198gold pituitary implantation, etc.