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Hyperprolactinemia

D’Ann Somerall, DNP, MAEd, CRNP, FNP-BC and William E. Somerall, Jr., MD, MEd Reviewed 06/2019
 


BASICS

DESCRIPTION

Hyperprolactinemia is an abnormal elevation in the serum prolactin level with multiple possible etiologies. 

EPIDEMIOLOGY

Prevalence

  • Predominant age: reproductive age

  • Predominant sex: fe...

DIAGNOSIS

HISTORY

  • Galactorrhea

  • Amenorrhea

  • Oligomenorrhea

  • Infertility

  • Osteoporosis/osteopenia

  • Decreased libido, impotence

  • Weight gain

  • Also may have signs and symptoms of pituitary enlargement:

    • Headache

    • Visual fi...

TREATMENT

GENERAL MEASURES

  • Discontinue offending medications, if any (1)[A].

  • Treat underlying causes (1)[A].

  • For asymptomatic patients with mild prolactin elevations, observation alone may be considered ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Depends on etiology

  • After at least 2 years of treatment, no tumor and prolactin levels normal may consider decreasing and stopping medication; mu...

REFERENCES

1
Hoffman AR, Melmed S, Schlechte J. Patient guide to hyperprolactinemia diagnosis and treatment. J Clin Endocrinol Metab.  2011;96(2):35A–36A. [View Abstract on OvidMedline]
2
Wang AT, M...

ADDITIONAL READING

  • Inancli SS, Usluogullari A, Ustu Y, et al. Effect of cabergoline on insulin sensitivity, inflammation, and carotid intima media thickness in patients with prolactinoma. Endocrine. ...

CODES

ICD10

E22.1 Hyperprolactinemia 

ICD9

253.1 Other and unspecified anterior pituitary hyperfunction 

SNOMED

  • 237662005 hyperprolactinemia (disorder)

  • 237668009 Pregnancy hyperprolactinemia (disorder)

  • 23766...

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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