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Unlike women, who most commonly have microprolactinomas, men usually present with macroprolactinomas, and their serum prolactin levels are generally much higher than those observed in women. [ 13 ] Long-term hyperprolactinaemia can lead to detrimental changes in bone metabolism as a result of hypoestrogenism and hypoandrogenism .
Prolactin inhibitors are mainly used to treat hyperprolactinemia (high prolactin levels). [1] Agonists of the dopamine D 2 receptor such as bromocriptine and cabergoline are able to strongly suppress pituitary prolactin secretion and thereby decrease circulating prolactin levels, and so are most commonly used as prolactin inhibitors. [1]
There are few treatments which increase prolactin levels in humans. Treatment differs based on the reason for diagnosis. Women who are diagnosed with hypoprolactinemia following lactation failure are typically advised to formula feed, although treatment with metoclopramide has been shown to increase milk supply in clinical studies.
Dopamine agonists are currently the preferred medication for suppressing lactation, which work by suppressing prolactin production. [3] Cabergoline (Dostinex™) is currently most effective option currently available, as it is available as a single dose (as opposed to bromocriptine which must be taken twice daily for 2 weeks.) [4] It may be prescribed in the case of breast abscess.
Changes in levels of certain hormones, such as prolactin or luteinizing hormone (LH) Mental health issues, such as depression, stress or anxiety Inflammation affecting the prostate gland or urethra
Cabergoline, sold under the brand name Dostinex among others, is a dopaminergic medication used in the treatment of high prolactin levels, prolactinomas, Parkinson's disease, and for other indications. [3] It is taken by mouth. Cabergoline is an ergot derivative and a potent dopamine D 2 receptor agonist. [4]
The effects of mildly elevated levels of prolactin are much more variable, in women, substantially increasing or decreasing estrogen levels. Prolactin is sometimes classified as a gonadotropin [17] although in humans it has only a weak luteotropic effect while the effect of suppressing classical gonadotropic hormones is more important. [18]
If prolactin levels remain high, an MRI scan of the pituitary gland to check for the presence of a prolactinoma should be ordered. [358] Otherwise, estrogen therapy may be restarted at a lower dosage. [358] Cyproterone acetate is particularly associated with elevated prolactin levels, and discontinuation of cyproterone acetate lowers prolactin ...