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Hyperprolactinemia

Menopause

Information on how to access prescribing information and adverse event reporting can be found at the bottom of the page.

About Hyperprolactinaemia 

Overview 

Hyperprolactinaemia is a condition characterized by an elevated level of prolactin in the blood.1 The consequences of this imbalance are varied but most commonly lead to hypogonadism, resulting in infertility, low libido, decreased bone mass, and, in women, oligomenorrhoea and/or amenorrhoea.1 

Hyperprolactinaemia occurs more frequently in women than men.1
The prevalence of hyperprolactinaemia varies based on the population under investigation.
It
is:1-3
• 0.4% in the general population
• 9%-17% in women with reproductive diseases
• 16%-30% in women with infertility
• ~ 5% among men who present with impotence or infertility

Pathophysiology

Prolactin, which is synthesized by the pituitary gland, primarily functions to stimulate and maintain the production of breast milk during pregnancy and breastfeeding.1,4
When prolactin levels are elevated in either women or men, gonadotropin-releasing hormone (GnRH) secretion is inhibited and gonadal function is affected, ultimately leading to infertility.4,5

     Adapted from Kaiser UK, 2012.6

Etiology

Hyperprolactinaemia can arise from pharmacologic, pathologic, physiologic, and idiopathic causes.1

Helix Image
 

Prolactinomas are the most common cause of hyperprolactinaemia, which account for approximately 40% of all pituitary tumors.7

Effects of Certain Medications

It is important to be aware that several different types of medications and drugs can cause increased serum prolactin levels.
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Adapted from Vilar L., et al and Peña KS., et al.

Please note some of these medications are not available in the UK

Identifying Common Symptoms

Understand what signs to look for and explore two patient case studies
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Learn more

Interpreting Test Results

Recognise which tests to order and what the results indicate
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Learn more

Selecting Treatment based on Guidelines

Determine therapy based on clinical and patient factors
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Learn more

Monitoring and Management

Learn how to tailor therapy based on follow-up testing
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Learn more

Estring (estradiol hemihydrate) prescribing information can be found here
Premarin (oestrogens, conjugated) prescribing information can be found here
Premique (medroxyprogesterone acetate oestrogens, conjugated) prescribing information can be found here​​​​​​   

References
1. Majumdar A, Mangal NS. Hyperprolactinemia. J Hum Reprod Sci. 2013;6(3):168-175.
2. Vilar L, Fleseriu M, Bronstein MD. Challenges and pitfalls in the diagnosis of    hyperprolactinemia. ArqBras Endocrinol Metabol. 2014;58(1):9-22.
3. Serri O, Chik CL, Ur E, Ezzat S. Diagnosis and management of hyperprolactinemia. CMAJ. 2003;169(6):575-815.
4. Endocrine
Society. The Hormone Foundation's patient guide to hyperprolactinemia diagnosis and treatment. https://academic.oup.com/jcem/article/96/2/35A/2709499. Accessed April 2022.

5. Marieb EN, Hoehn K. Chapter 28: Pregnancy and human development. In: Human Anatomy & Physiology, 11th ed. Hoboken, NJ: Pearson Education; 2018.
6. Kaiser UB. Hyperprolactinemia and infertility: new insights. J Clin Invest. 2012;122(10):3467-3468.
7. Melmed S,
Casanueva FF, Hoffman AR, et al; Endocrine Society. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(2):273-288.
8. Peña
KS, Rosenfeld JA. Evaluation and treatment of galactorrhea. Am Fam Physician. 2001;63(9):1763- 1670.​​​​​​​

PP-UNP-GBR-0580. June 2022

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PP-PFE-GBR-3863. November 2021

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