Prolactin Elevation as a Manifestation of Endocrine Disorder

Prolactin elevation is a manifestation of endocrine disorder. Generally, it often occurs in women. Persistent elevation of prolactin can lead to menstrual irregularity, infertility, and other phenomena in women. Prompt treatment is required for prolactin elevation. In addition to active treatment, attention should also be paid to daily diet, including eating more vegetables and fruits. Appropriate exercise and regular lifestyle habits should be maintained, and staying up late should be avoided.

1. When does prolactin elevation require treatment?

In clinical practice, patients with endocrine abnormalities may have hyperprolactinemia, which is characterized by abnormally elevated prolactin levels in the blood. This can affect gonadal function and female sexual function. Hyperprolactinemia can inhibit the menstrual cycle, causing menstrual cycle disorders and even amenorrhea. Hyperprolactinemia is commonly caused by inappropriate secretion from the pituitary gland, as prolactin is secreted by the pituitary gland and released into the blood. Therefore, the presence of a pituitary tumor can lead to excessive secretion of prolactin, resulting in hyperprolactinemia. Hyperprolactinemia can also promote lactation during the female breastfeeding period. Therefore, in clinical practice, people with amenorrhea-galactorrhea syndrome are often found to have hyperprolactinemia. Regardless of whether hyperprolactinemia causes abnormal organ function, if prolactin levels exceed the normal range, it is recommended to consult a specialist in endocrinology to identify the cause of hyperprolactinemia. Once a pituitary tumor is diagnosed, treatment should be targeted accordingly.

2. Can prolactin elevation be cured?

Normal prolactin levels should be less than 30ng/mL. Prolactin levels between 30ng/mL and 100ng/mL are mainly seen after exercise, during pregnancy and lactation, under stress, and during the secretory phase of the menstrual cycle. Other medications, such as domperidone, cimetidine, estrogens, and tricyclic antidepressants, can also cause elevated prolactin levels. If prolactin elevation is caused by the above factors, removing the relevant triggers or discontinuing the medication can lower prolactin levels to normal. However, prolactin levels less than 100ng/mL are more commonly associated with pathological factors, with pituitary tumors being the most common cause. Treatment with bromocriptine can effectively reduce prolactin levels to normal, but continuous medication is required as discontinuation may lead to recurrence. In cases of large prolactinomas, surgical removal by neurosurgeons may be considered. Therefore, prolactin elevation reaching a pathological state can only be controlled with Western medicine or surgery, and complete cure is often difficult to achieve.

3. Can prolactin elevation decrease spontaneously?

Prolactin elevation may decrease spontaneously in some cases, while others may require treatment for reduction. The main determinant is the cause of prolactin elevation. For instance, prolactin levels can increase significantly during late pregnancy or after childbirth, which is considered a physiological elevation and prolactin levels will decrease spontaneously. Additionally, certain medications, such as tricyclic antidepressants, metoclopramide, and estrogens, can also lead to elevated prolactin levels, and prolactin levels will return to normal after discontinuation of these medications. However, if prolactin elevation is caused by a prolactinoma in the pituitary gland, treatment with medications such as bromocriptine is necessary for reduction. In some cases, surgical intervention may be required for prolactin levels to decrease. Other diseases, such as hypothyroidism, chronic kidney failure, and liver cirrhosis, can also lead to elevated prolactin levels, and active treatment of the underlying disease is required for prolactin levels to decrease.