Hyperprolactinemia

Prolactin is a hormone responsible for lactation. Hyperprolactinemia occurs when prolactin levels are too high in your blood. This rare condition is more common in women than in men.

Symptoms in women include: 

• Breast discharge
• Menstrual irregularities
• Amenorrhea (no period)
• Low libido

Symptoms in men include:

• Erectile dysfunction
• Decreased libido
• Hypogonadism (not producing testosterone)
• Breast tenderness

The most common cause of hyperprolactinemia is a pituitary gland tumor. However, other factors such as pregnancy, chest wall injury, stress, excessive exercise, nipple piercings or stimulation can also cause high prolactin levels. Additionally, medications like antipsychotics or those that suppress dopamine production may cause hyperprolactinemia.

If left untreated, complications can include: 

• Infertility
• Osteoporosis
• Vision loss (in large tumors)

Lab Testing
A blood test will measure your prolactin levels, luteinizing hormone, and estradiol (women) or testosterone (men).

Imaging
Imaging scans, like an MRI, help your doctor assess your pituitary gland for tumors. 

Medications
Dopamine agonists (cabergoline and bromocriptine) are the most common treatment for hyperprolactinemia. These medications mimic the function of dopamine in the brain, which can lower prolactin production and shrink the pituitary tumor.

Transsphenoidal Surgery
If dopamine agonists don’t correct your prolactin levels or you’re unable to take or tolerate medications, transsphenoidal surgery may be recommended. During this minimally invasive procedure, a doctor inserts a tube through your nasal passage and the sphenoid sinus to access the pituitary gland at the base of your brain. Your surgeon will remove all or as much of the tumor as possible. Minimally invasive procedures require smaller incisions than open surgery and mean you experience less pain, faster recovery, and fewer complications.

Radiation Therapy
It is rare, but radiation may be needed if surgery or medications are ineffective.

Pituitary Center of Excellence
Duke Health experts are leaders in advanced treatment for people with all types of pituitary disorders. Collectively, our pituitary disorder clinics in Durham are designated a Pituitary Center of Excellence by the Pituitary Network Association, an international non-profit organization created to help people with pituitary tumors and disease.

Leading Experts in Rare Pituitary Gland Disorders
Duke is one of the few hospitals equipped to treat central hyperthyroidism and other rare pituitary gland disorders. People are referred to our neuroendocrinologists and specialized surgeons from all over the United States.

Collaborative, All-In-One Pituitary Clinic
For your convenience, we offer a special pituitary clinic that allows you to see an endocrinologist, neurosurgeon, and ophthalmologist in one day and in one location. These experts meet with you to review your case, order tests, and offer recommendations for next steps.