What hyperprolactinemia is
Hyperprolactinemia is a prolactin level above the reference range. Prolactin is the anterior pituitary hormone that drives milk production.
Why does the level go up?
A raised level needs a reason, and this topic is built around one idea about how prolactin is kept down. The hypothalamus holds prolactin under continuous inhibition and does not drive it. So anything that interrupts or bypasses that inhibition raises the level. The causes are the ways in. Dopamine from the hypothalamus is the brake that holds prolactin down, and Prolactin Regulation and Causes of Hyperprolactinemia explains it.
What does each note explain?
The rest of the topic is the list of ways the brake is cut and what the high level then does. In learning order:
- Prolactin Regulation and Causes of Hyperprolactinemia: how dopamine holds prolactin down, which signals raise it, and the full range of causes, from physiological states and drugs to lesions that interrupt the dopamine route.
- Prolactinoma and the Clinical Features of Hyperprolactinemia: what a prolactinoma is, how it differs by size and sex, and how the picture divides into effects of the hormone and effects of the tumour’s bulk, in women, men and before puberty.
- Galactorrhea and Hypogonadism in Hyperprolactinemia: why the breast discharge needs estrogen as well as prolactin, and how a raised level suppresses the reproductive hormones.
- Diagnosis of Hyperprolactinemia: how the other causes are excluded first, how imaging and the level are read together, and the laboratory traps that can mislead.
- Treatment of Hyperprolactinemia: who needs treatment, dopamine agonists, when they can be stopped, when surgery is chosen, pregnancy, and drug-induced cases.
Where to start
Begin with Prolactin Regulation and Causes of Hyperprolactinemia: what holds prolactin down, and what has to go wrong for it to rise?