[The diagnosis of hyperprolactinemia in clinical practice]

Prolactin is a pituitary hormone that plays pivotal role in a variety of reproductive functions. Hyperprolactinemia is a common condition that can result from a number of causes; including use of medications and hypothyroidism, as well as pituitary disorders. Depending on the cause and consequences of hyperprolactinemia, selected patients require specific treatment. The underlying cause of hyperprolactinemia, sex, age and reproductive status must be considered. Management of this condition depends heavily on the cause and on the effects it has on the patient. The definition of the hyperprolactinemia is not uniformed, and in various clinical settings various criteria of this status are used. In the identification of hyperprolactinemia not only simple measurements of the prolactin serum level are used, the dynamic tests with the use of dopamine antagonists have a special role as well. Neither the measurement of the serum prolactin level, nor dynamic tests with dopamine antagonists are able to determine the presence of macroprolactin molecules in the serum, and this can lead clinicians to establish the false diagnosis of hyperprolactinemia.