Hyperprolactinemia is a medical condition characterized by elevated levels of prolactin, a hormone primarily responsible for milk production after childbirth. While prolactin plays an essential role in reproduction and lactation, too much of it can disrupt normal hormonal balance, leading to symptoms such as menstrual irregularities, infertility, and sexual dysfunction. Knowing what causes hyperprolactinemia is the first step toward effective diagnosis and treatment.
Here’s a closer look at the various causes of hyperprolactinemia:
- Physiological Causes
Certain normal body states can raise prolactin levels temporarily. Pregnancy and breastfeeding are the most common. Stress, physical exercise, sleep, and nipple stimulation also naturally increase prolactin production. - Drugs
Some medications interfere with dopamine, a brain chemical that normally suppresses prolactin secretion. Common culprits include antipsychotics like risperidone and haloperidol, antidepressants such as SSRIs, certain blood pressure medicines like verapamil, opiates, and estrogen-containing oral contraceptives. - Pituitary Lesions
Pituitary adenomas (tumors), especially prolactinomas that secrete excess prolactin, are a frequent pathological cause. Other pituitary abnormalities including cysts, inflammation (hypophysitis), or damage after surgery or radiation can also elevate prolactin levels. - Hypothalamic Lesions
The hypothalamus regulates prolactin via dopamine. Tumors, trauma, infiltration by diseases like sarcoidosis, or interruption of the pituitary stalk can disrupt this control, increasing prolactin. - Endocrine Disorders
Conditions such as hypothyroidism cause increased release of TRH, a hormone that stimulates prolactin secretion. Other endocrine issues like polycystic ovary syndrome (PCOS) or chronic kidney disease, which reduces prolactin clearance, may contribute as well. - Miscellaneous
Chest wall trauma or irritation, macroprolactinemia (presence of large prolactin complexes with reduced biological activity), and some rarely identified factors fall under miscellaneous causes. - Idiopathic
In some cases, after thorough evaluation, no specific cause can be identified. These are termed idiopathic hyperprolactinemia.
Conclusion
Hyperprolactinemia arises from a wide range of physiological, pharmacological, pathological, and sometimes unknown causes. Proper evaluation by healthcare professionals helps identify the underlying reason, guiding appropriate treatment strategies. Whether through medication, surgery, or managing underlying conditions, effective control of prolactin levels can restore hormonal balance and fertility for many affected individuals.