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Overview

Hyperprolactinemia: Treatment, Procedure, Cost and Side Effects

How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

How is the treatment done?

Hyperprolactinemia is a condition where there is an abnormally high level of the hormone prolactin in the blood. Prolactin is a hormone that is produced by the pituitary gland. Prolactin hormone controls lactation and development of breasts in pregnant women. Normal level of prolactin in females is <500 mlU/L and for males is less than 450 mlU/L. Increased prolactin levels in blood can cause irregular menstruation or complete stoppage of menstruation, sexual dysfunction, and even infertility in females. In males, increased prolactin levels can cause sexual dysfunction, decreased libido, erectile dysfunction, gynecomastia, and infertility.

Hyperprolactinemia can be caused by a number of different factors, both pathological and physiological. Physiologically, prolactin is secreted in the blood in increased amounts during pregnancy and in early post parturition period while breastfeeding is carried out. Pathologically, hyperprolactinemia can be caused by either a disinhibitory activity like a pituitary stalk compression due to a localized tumor, or due to increased production of prolactin caused by a type of pituitary gland tumor called prolactinoma. Some systemic diseases like renal failure, hypothyroidism, epileptic seizures, etc. can also cause hyperprolactinemia. A number of medications induce prolactinemia, especially those that reduce dopamine production or reception at the pituitary as dopamine is the natural antagonist to prolactin, keeping each other in balance.

Treatment of hyperprolactinemia target either the symptoms or the tumor if a tumor is the cause. Symptoms caused by hyperprolactinemia like amenorrhea, gynecomastia, etc. are treated as they appear. Medications causing hyperprolactinemia are best withdrawn if possible, if not they are to be supplemented by dopamine agoniststo balance prolactin levels. Radiation treatment can be prescribed in some cases. In cases where no response to dopamine agonists is visible, a trassphenoidal surgery to remove a pituitary tumor may be prescribed.

Who is eligible for the treatment? (When is the treatment done?)

Treatment for hyperprolactinemia is directed towards the symptoms produced by hyperprolactinemia, or towards any tumor growths causing the condition. Dopamine agonists have been shown to be effective in decreasing prolactin secretion. Symptoms caused by hyperprolactinemia include hypothyroidism and osteoporosis among others. These conditions need to be treated individually. In cases where medications cause hyperprolactinemia, withdrawal of the medication is advised if possible. In tumors that grow rapidly and uncontrollably, radiation therapy is prescribed. Surgical treatment is advised when there is no response to dopamine agonists or medicine resistant tumors.

Who is not eligible for the treatment?

People showing symptoms of consistently high prolactin levels in blood show some typical symptoms in both males and females. These include irregular or absent menstruation in females, sexual dysfunction in both males and females, and gynecomastia in males. Symptoms in males are not as easily detectable as decreased libido is not easily attributable to hyperprolactinemia and gynecomastia can occur due to a number of reasons. A tumor causing the problem can apply pressure on the optic chiasm, causing headaches and consistent vision problems. Patients showing symptoms of hypothyroidism and osteoporosis need to be checked for hyperprolactinemia in case increased prolactin is the cause of these symptoms. All patients with increased prolactin levels are eligible for treatment with dopamine agonists. For those with very quickly growing tumors, radiation therapy is advised. For those who do not respond to medicines or radiations, surgical treatment is advised.

Are there any side effects?

Hyperprolactinemia is normally caused during pregnancy and during breastfeeding, hence pregnant women and breastfeeding women do not need treatment. Mental stress can also cause an increase in prolactin levels in blood and hence do not need treatment as these levels subside soon.

What are the post-treatment guidelines?

Side effects of the treatment depend upon the treatment approach undertaken. If medications cause hyperprolactinemia and these medicines are withdrawn, the original disease for which these medications were prescribed remain untreated. Radiation therapy is associated with a number of side effects including fatigue, nausea, weakness, etc.

How long does it take to recover?

Recovery from hyperprolactinemia usually depends on the treatment approach undertaken. Even after blood prolactin levels come down, other conditions caused due to increased prolactin levels also take time to recover.

Successful recovery from hyperprolactinemia needs to be followed up with regular checkups, a healthy diet and an active lifestyle.

What is the price of the treatment in India?

Recovery from hyperprolactinemia usually depends on the treatment approach undertaken. Even after blood prolactin levels come down, other conditions caused due to increased prolactin levels also take time to recover.

Are the results of the treatment permanent?

Treatment for hyperprolactinemia ranges between Rs. 50 for a thyroid hormone replacement therapy, going up to Rs. 50 lakhs for tumor surgeries.

What are the alternatives to the treatment?

Treatment with dopamine antagonists are usually not permanent and need to be followed up regularly. Other methods like surgery to remove tumors are usually permanent as it targets the cause of increased prolactin levels if surgical tumor removal is successful.

Popular Questions & Answers

Hi, I have done a blood test and the prolactin is showing high 363. Testosterone is showing normal 12.8 and estradiol 22.7. Please advise.

MBBS, MS - Obstetrics and Gynaecology, Fellowship in Day care Gynaecological Endoscopy
Gynaecologist, Kolkata
Hello. There are many causes of increased prolactin level but it is mandatory to get contrast mri of pituitary gland done once prolactin is more than 100 to rule out pituitary microadenoma or pituitary macroadenoma. At the same time other causes o...

Hello doctor, I am 22 year old I have a serum prolactin problem I have consulted to the doctor she given 8 tablet for 2 month so now its normal but. I have a doubt why its happening? Is it a serious problem in future please help me?

MD - Homeopathy, BHMS
Homeopathy Doctor, Vadodara
It is a serious problem mostly occur with pcod. The tablets given to you will give just temporary solution and the complaints may return. Better take homoeopathic treatment.
2 people found this helpful

I am using bromergon pills or I think it is Bromocriptine in english for my Hyperprolactinemia. Can I use zeolit when I am drinking my pills?

MD - Obstetrtics & Gynaecology, FCPS, DGO, Diploma of the Faculty of Family Planning (DFFP)
Gynaecologist, Mumbai
any drug can be prescribed with details required by only doctor who has examined you or can examine you so go to such medical practitioner.

Hi what is treatment for rise in prolactin. if your Breast has secretion after pressing it.

MD - Homeopathy, BHMS
Homeopath, Vadodara
The treatment cannot be detailed like that. You will need to consult. It is a serious hormonal imbalance.

Hello doctor, I am on treatment of cabergoline0. 250 mg for high prolactin which is 42. From few days I am feeling itching in my nipples with pain and burning sensation. Is this a cause to worry? Please help.

MD, MBBS
Dermatologist, Chennai
You are suffering from Allergic dermatitis. Medicine available for good improvement. As the treatment varies depending on the severity. Send photos of the affected area, by direct online consultation for accurate diagnosis and treatment.
1 person found this helpful

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