Unit 10 - Hyperprolactinemia

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Hyperprolactinemia Symptoms - Women

- Galactorrhea (increased milk prod.) - Anovulatory Amenorrhea (absence in ovulation and menses)

Hyperprolactinemia Symptoms - Men

- Gynecomastia (breast enlargement) - Erectile Dysfunction

Hyperprolactinemia Causes - Damage to Hypothalamic-Pituitary Stalk

- contains vessels that connect hypothalamus to pituitary - due to trauma, nearby tumors, brain surgery

Hyperprolactinemia Diagnosis

- detecting high levels of prolactin in blood - Pregnancy check - Brain MRI (look for prolactinoma)

Hyperprolactinemia Causes - Physiologic Hyperprolactinemia

- during preg. and lactation, typically returns to normal after

Hyperprolactinemia Symptoms - Prolactinoma

- headaches + impaired vision (due to pressing on optic nerve)

Prolactin - Women

- increased levels of estrogen in pregnant women leads to increased prolactin - stimulates alveolar cells in breasts (divide + enlarge) - once baby is born, lactogenesis begins

Prolactin Regulation - Breastfeeding women

- inhibits release of gonadotropin-releasing hormone - luteinizing + follicle stimulating hormone decreases estrogen in response

Lactotroph Cells

- on anterior of pituitary - secrete prolactin

Hyperprolactinemia Causes - Prolactinoma

- pituitary adenoma, benign tumor of lactotroph cells - increased amt. of prolactin - Hypothyroidism (Hypothalamus tries to increase thyroid hormones by increasing Thyrotropin Releasing Hormone, increased prolactin levels)

Prolactin - Men

- stimulates testosterone production

Hyperprolactinemia Treatment

- varies on underlying cause - Dopamine Agonists (Bromocriptine) - Prolactinoma >> Surgery - Hypothyroidism >> Replacement thyroid hormones

Prolactin Regulation - Regular people

1. Hypothalamus secretes dopamine (prolactin inhibiting factor) OR 2. Secretes Thyrotropin Releasing Hormone (prolactin releasing hormone) stimulates prolactin release, looping back to first step to force negative feedback.

Hyperprolactinemia Causes - Medication

[Dopamine Antagonists] - remove inhibition on lactotroph cells [Estrogens] - stimulate lactotrophs to produce prolactin


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