Hyperprolactinemia

William E Somerall Jr, MAEd, MD and D'Ann Wilson Somerall, FNP-BC, MAEd, FAANP, DNP, CRNP Reviewed 06/2022

BASICS

DESCRIPTION

Hyperprolactinemia is an abnormal elevation in the serum prolactin level, from either physiologic or pathologic influences of the lactotroph cells of the pituitary gland.

EPIDEMIOLOGY

DIAGNOSIS

Based on clinical history, physical exam, and laboratory findings

HISTORY

Galactorrhea
Amenorrhea or oligomenorrhea
Infertility
Osteoporosis/osteopenia
Decreased libido, impotence
Weight gain
Also ...

TREATMENT

GENERAL MEASURES

Discontinue offending medications, if any (4)[A].
Treat underlying causes (4)[A].
For asymptomatic patients with mild prolactin elevations, observation alone may be considere...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Reevaluate lab levels after one month; if normal, continue the initial dose. If lab levels do not decrease, but pt experiences no side effects increase cabergolin...

REFERENCES

Somerall WE Jr,, Somerall DW. Hyperprolactinemia: The ABCs of diagnosis and management. Women's Healthcare. 2020;8(6):6-12.

Casanueva FF, Molitch ME, Schlechte JA...

ADDITIONAL READING

Klibanski A. Clinical practice. Prolactinomas. N Engl J Med. 2010; 362(13): 1219– 1226. [View Abstract]

CODES

ICD10

E22.1 Hyperprolactinemia

SNOMED

237662005 hyperprolactinemia (disorder)
237668009 Pregnancy hyperprolactinemia (disorder)
237666008 Physiological hyperprolactinemia (disorder)
237665007 Drug-in...

CLINICAL PEARLS

If a cause for hyperprolactinemia cannot be found by history, examination, and routine laboratory testing, an intracranial lesion might be the cause and brain MRI with specific pituita...

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