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Hyperprolactinaemia (also spelled hyperprolactinemia) is a condition characterized by abnormally high levels of prolactin in the blood. In women, normal prolactin levels average to about 13 ng/mL, while in men, they average 5 ng/mL. The upper normal limit of serum prolactin is typically between 15 and 25 ng/mL for both genders. [1]
Hyperprolactinaemia, or excess serum prolactin, is associated with hypoestrogenism, anovulatory infertility, oligomenorrhoea, amenorrhoea, unexpected lactation and loss of libido in women and erectile dysfunction and loss of libido in men. [80] Causes of Elevated Prolactin Levels
In women, hyperprolactinemia is often associated with amenorrhea, a condition that resembles the physiological situation during lactation (lactational amenorrhea). Mechanical detection of suckling increases prolactin levels in the body to increase milk synthesis.
High levels of prolactin during pregnancy and breastfeeding also increase insulin resistance, increase growth factor levels (IGF-1) and modify lipid metabolism in preparation for breastfeeding. During lactation, prolactin is the main factor maintaining tight junctions of the ductal epithelium and regulating milk production through osmotic balance.
The persistent hypogonadism associated with hyperprolactinemia can lead to osteoporosis. Treatment significantly improves the patient's quality of life. If the goal is to treat hypogonadism only, patients with idiopathic hyperprolactinemia or microadenoma can be treated with estrogen replacement therapy and prolactin levels can be monitored.
Across Europe, neonatal lactation was called "witch's milk", "Hexenmilch" and "lait de sorciere", and it was accused of being a potential source for witchcraft. [ 13 ] Some communities believed that women who has sold their souls to Satan in return for mystical powers would persecute babies by sucking their mammary glands and leaving "witches ...
Cabergoline is considered the best tolerable option for hyperprolactinemia treatment although the newer and less tested quinagolide may offer similarly favourable side effect profile with quicker titration times. Approximately 200 patients with newly diagnosed Parkinson's disease participated in a clinical study of cabergoline monotherapy. [16]
Galactorrhea can also be caused by antipsychotics that cause hyperprolactinemia by blocking dopamine receptors responsible for control of prolactin release. Of these, risperidone is the most notorious for causing this complication. [5] Case reports suggest proton-pump inhibitors have been shown to cause galactorrhea.