Interní Med. 2008; 10(12): 549-554

Hyperprolactinemia in practice

prof. MUDr Josef Marek DrSc

III. interní klinika VFN a 1. LF UK, Praha

The prevalence of prolactin secreting adenomas requiring treatment is estimated 600–700 per million inhabitants. The prevalence of all hyperprolactinemias, i.e. also of nonhypophyseal origin in nonselected population is estimated to be 0.4%. It can be encountered in a number of physiological states, with use of some medications, and it accompanies endocrinological and nonendocrinological diseases. Differential diagnoses of hyperprolactinemias may not be easy. Hyperprolactinemia causes infertility, menstrual cycle disorders with hypoestrinism and galactorhea in females and loss of libido and potency with decrease of testosterone secretion in males. If hyperprolactinemia causes clinical manifestation, it should be treated. The treatment of first choice is with dopaminergic agonists. Bromocriptin, quinagolid and cabergolin are available in our country. High doses of cabergolin may increase the incidence of heart valve insufficiencies. However usually low doses, after which valve defects were not observed, are used during treatment of hyperprolactinemias. Only a small portion of prolactin secreting adenomas are resistant to medical therapy or is not tolerating it. Then neurosurgery and radiation with gamma knife play a specific role. Specific rules are important for treatment of prolactin secreting adenomas in pregnancy.

Keywords: Key words: hyperprolactinemia, prolactinoma, therapy with dopaminergic agonists.

Published: January 1, 2009  Show citation