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Hyperprolactinemia, characterized by abnormally high levels of prolactin, may cause galactorrhea (production and spontaneous flow of breast milk), infertility, and menstrual disruptions in women. In men, it can lead to hypogonadism, infertility and erectile dysfunction. Prolactin is crucial for milk production during pregnancy and lactation.
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. Radiation treatment is another option.
Dopamine agonists for infertility treatment are commonly administered to hyperprolactinemic anovulation patients. Both bromocriptine and cabergoline are the first-line dopamine agonist in hyperprolactinemia treatment. [46] Cabergoline is currently more preferred than bromocrptine due to its higher efficacy and fewer side effects like nausea. [53]
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]
The most common complex found in blood consists of prolactin and immunoglobulin G (IgG). [1] While the free prolactin hormone is active, prolactin in the macroprolactin complex does not have any biological activity in the body and is considered benign. [2] However, macroprolactin is detected by all Laboratory tests that measure prolactin in ...
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. [2] It is taken by mouth. Cabergoline is an ergot derivative and a potent dopamine D 2 receptor agonist. [3]
If symptoms of hyperprolactinemia are present, dopamine agonists, such as bromocriptine, are first line treatment which act by inhibiting production of prolactin by the pituitary and can shrink a prolactin-secretin lesion (i.e. prolactinoma) if present. [18]
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.