What are the treatments for hyperprolactinemia?

Many female patients with hyperprolactinemia often report that their menstruation is not normal and regular, sometimes the menstrual flow is heavy and their menstrual period is very long. In short, they have serious menstrual irregularities. In fact, hyperprolactinemia is a common disease among a large number of women, which will bring a lot of inconvenience and harm to women's work and life. What are the treatments for hyperprolactinemia? It is also a treatment issue that the majority of female patients pay special attention to. Let's learn about it together.

TCM treatment of hyperprolactinemia:

Traditional Chinese medicine believes that the cause and pathogenesis of this disease is relatively complex, but in principle it can be divided into two categories: deficiency and excess. Deficiency refers to liver and kidney deficiency, insufficient essence and blood, and an empty blood sea. When there is no blood to flow, amenorrhea will occur; when qi and blood are weak and kidney qi is not solid, milk will overflow. It is actually caused by liver depression and qi stagnation, blood stasis and phlegm obstruction, which block the meridians and force menstrual blood to flow downward; or it is caused by heat accumulation in the liver meridians and abnormal blood secretion, which forces milk to overflow. Due to insufficient endowment, the kidney qi is not strong, the essence is not sufficient, the liver blood is deficient, the Chong and Ren meridians are not nourished, and cannot be transformed into menstrual blood; or due to sexual overwork or long-term illness, the kidney essence is depleted, the liver blood is also deficient, the essence and blood are scarce, the source is cut off, the Chong and Ren meridians are damaged, and there is no blood to flow out of the uterus, resulting in amenorrhea.

What are the treatments for hyperprolactinemia?

1. Treatment of the cause and primary disease

For example, eliminate adverse mental stimulation, stop taking HPRL-inducing drugs, and actively treat primary diseases such as pituitary tumors, hypothyroidism, Cushing's disease, etc.

2. Anti-prolactin-bromocriptine therapy

Bromocriptine is a semi-synthetic ergoline derivative and a dopamine receptor agonist. It can promote the synthesis and secretion of PRL-IH and inhibit the synthesis and release of PRL through the receptor mechanism. It also directly acts on pituitary tumors and PRL cells to curb tumor growth and inhibit the secretion of PRL, GH, TSH and ACTH.

Bromocriptine therapy is suitable for all types of HPRL and is also the first choice for pituitary adenomas (micro/macroadenomas), especially for young infertile women who hope to have children. The dosage is 2.5-7.5 mg/d, orally. Other anti-prolactin drugs include: Levodopa (Levo-Dopa), octahydrobenzoquinoline (CV205-502), vitamin B6, etc. See the Anti-prolactin section in the Endocrine Therapy chapter for details.

3. Ovulation induction treatment

It is suitable for patients with HPRL, anovulatory infertility, and those who cannot successfully ovulate and become pregnant after simple bromocriptine treatment. That is, a comprehensive therapy with bromocriptine as the main drug and other ovulation-inducing drugs in combination: ① bromocriptine-CC-hCG; ② bromocriptine-hMG-hCG; ③ GnRH. Pulse therapy - bromocriptine, etc. Combined therapy can save antiprolactin, shorten the treatment cycle and improve the ovulation rate and pregnancy rate.

4. Surgical treatment

It is suitable for patients with giant adenomas that present compression symptoms, as well as patients with drug-resistant tumors, patients who are unresponsive to bromocriptine treatment, and patients with septicomas that secrete multiple pituitary hormones. The current trans-sphenoidal microsurgery is safe, convenient, and easy to perform, and its efficacy is similar to bromocriptine therapy. Using bromocriptine before and after surgery can improve the efficacy. The disadvantages of surgery are: if the pituitary tumor has no obvious capsule and unclear boundaries, the surgery is difficult to be thorough or may cause damage, resulting in cerebrospinal fluid nasal fistula and secondary pituitary dysfunction.

5. Radiation therapy

It is suitable for non-functional tumors of the HP system and those who are not responsive to drug and surgical treatments. Irradiation methods include: deep X-rays, 60Co, alpha particles and proton rays. Isotope 90 yttrium, 198 gold pituitary implants, etc. Prognosis: The dose of bromocriptine should be reduced gradually. If it is stopped immediately, rebound will occur. At the same time, pay attention to health care.

People with hyperprolactinemia can eat lettuce. Suggestions: Lettuce has the effects of analgesia and hypnosis, lowering cholesterol, auxiliary treatment of neurasthenia, diuresis, promoting blood circulation, and antiviral. Patients with hyperprolactinemia are advised to eat a light diet, reduce spicy, irritating and greasy foods, eat more fresh vegetables and fruits, and supplement with adequate vitamins.

Diseases such as hyperprolactinemia are often caused by many reasons. Female patients must pay great attention to it. Patients also have a deep understanding of the treatments of hyperprolactinemia. This type of disease also requires long-term conditioning to improve. Patients with hyperprolactinemia must strengthen physical exercise in daily life to improve their immunity. They should also combine work and rest in their daily work and pay more attention to rest to keep themselves healthy.