Clinical presentation of hyperprolactinemia

Prolactin is a polypeptide hormone essential for lactation. Its production in the lactotroph cells of the anterior pituitary is regulated primarily by the inhibitory action of hypothalamic dopamine. Hyperprolactinemia is the most common endocrine disorder of the hypothalamic-pituitary axis, occurring mostly in women and presenting most commonly with amenorrhea and galactorrhea. Causes of hyperprolactinemia include physiologic, pharmacologic and pathologic factors; pituitary adenoma is a common pathologic cause. Women may present with decreased libido, infertility, oligomenorrhea/amenorrhea and galactorrhea. Men may present with decreased libido, infertility, gynecomastia or impotence. In the absence of an identifiable and treatable underlying cause, hyperprolactinemia is generally treated with dopamine agonist medications.