What to do if prolactin is high? Treatment of the cause is the key

The secretion of prolactin is affected by many factors. If prolactin is high, you should pay attention. Drug factors, strenuous exercise, nerve stimulation, pituitary disorders, etc. are common causes. The key to treating high prolactin is to find the cause and treat it accordingly.

1. How to treat high prolactin

1. It is etiological treatment, that is, different treatment methods are adopted for different causes. If it is caused by drugs, the drugs should be stopped first. If it is caused by hypothyroidism, thyroxine tablets can be taken for replacement therapy. If it is a pituitary tumor, it can be treated with drugs or surgery according to the size of the tumor.

2. Inhibit the secretion of prolactin. Bromocriptine is the first choice drug. This drug can inhibit the synthesis and secretion of prolactin, control the growth of pituitary microadenomas, and even significantly shrink the tumor. The common side effects of bromocriptine are nausea, headache, fatigue and constipation. Therefore, the medication should be used under the guidance of a doctor. Data show that prolactin can be significantly reduced after one week of medication, galactorrhea will stop and menstruation will resume after 2-4 weeks of medication, and ovulation and pregnancy can occur after 3-6 months of medication.

3. Combination treatment: Patients with hyperprolactinemia who want to have children can be treated with bromocriptine first. If ovulation still cannot be restored, ovulation-inducing drugs can be added.

2. Causes of high prolactin

1. Hypothalamic disorders

Diseases of the hypothalamus and adjacent areas, such as encephalitis, craniopharyngeal tumor, pineal tumor, partial hypothalamic infarction, pseudotumor cerebri, pituitary stalk transection, etc., can cause a decrease in prolactin-inhibiting factor produced by the hypothalamus, or an increase in prolactin-releasing factor and thyrotropin-releasing factor. The former can cause prolactin to be produced blindly due to the loss of inhibition, while the latter two directly promote the increase of prolactin production.

2. Pituitary disorders

Mainly various tumors in the pituitary gland. In addition, some cases of empty sella syndrome and hyperpituitarism can also cause galactorrhea and amenorrhea.

Primary hypothyroidism

When the thyroid gland is hypothyroid, the information about insufficient thyroid secretion is transmitted to the hypothalamus through feedback, causing the hypothalamus to produce a large amount of thyrotropin-releasing factor. This factor, while stimulating the pituitary gland to secrete thyroid-stimulating hormone, can also stimulate the excessive secretion of pituitary prolactin and cause galactorrhea.

4. Drug Factors

Sedatives that act on the central nervous system, such as chlorpromazine and morphine, can reduce the content of catecholamines in the hypothalamus, thereby reducing the activity of prolactin-releasing factor produced by the hypothalamus; antihypertensive drugs such as methyldopa and reserpine can inhibit the release of prolactin-inhibiting factor; metoclopramide can stimulate excessive secretion of pituitary prolactin.

5. Nerve stimulation

Irritation of the skin in certain parts of the body, especially the chest, including severe pain caused by peripheral nerve damage, can be transmitted to the hypothalamus through nerves and cause an increase in prolactin. Such as chest surgery, burns, shingles on the chest and back, etc.