What to do if hyperprolactinemia is discovered before pregnancy

What should I do if I find hyperprolactinemia before pregnancy? Many patients with hyperprolactinemia do not know about this disease, so today our editor will take you to a comprehensive understanding of the causes, clinical manifestations and hazards of hyperprolactinemia. Next, let's listen to the editor's introduction!

Prolactin is a protein hormone secreted by the pituitary gland. Its main function is to stimulate the growth of breast tissue and the production of milk. In the menstrual cycle, the secretion of PRL in the follicular phase is lower than that in the luteal phase, and is more synchronized with the changes in LH. Dopamine and γ-aminobutyric acid can inhibit the secretion of PRL, thyrotropin-releasing hormone can stimulate the synthesis of PRL, and vasodilatory intestinal peptide can promote the release of PRL. The effect of normal levels of PRL on the secretion of gonadotropin is not very clear, but excessive PRL can cause dysfunction of the gonadal axis.

1. Causes

Common causes of primary hyperprolactinemia include pituitary prolactin tumors, empty sella syndrome, hypothalamic-pituitary diseases, idiopathic PRL elevation, etc.; common causes of secondary hyperprolactinemia include drug-induced PRL elevation, primary hypothyroidism, PCOS, adrenal insufficiency, cirrhosis, chronic renal failure, etc.

2. Clinical manifestations

(1) Menstrual changes: The typical manifestation of HPRL is amenorrhea, and it can also manifest as irregular menstruation (such as infrequent menstruation, scanty menstruation, etc.), ovulation disorders, luteal insufficiency, infertility, etc.

(2) Lactation: Milk can be seen during spontaneous lactation or when squeezing both breasts. There is no absolute positive correlation between the level of PRL and the level of PRL, which may be related to factors such as the heteromorphism of PRL and its immune activity, biological activity, and receptor binding rate.

(3) Other manifestations: If left untreated for a long time, estrogen deficiency may lead to osteoporosis, or the progression of pituitary tumors may cause headaches and visual impairment.