Idiopathic hyperprolactinemia - A challenge for primary care.

Area of Science:

• Endocrinology
• Reproductive Health

Background:

• Hyperprolactinemia, elevated serum prolactin, commonly affects women, presenting with symptoms like galactorrhea, oligomenorrhea, amenorrhea, or infertility.
• While often caused by identifiable factors, rare instances of idiopathic hyperprolactinemia, resolving without intervention, have been documented.

Observation:

• A 39-year-old woman experienced amenorrhea for four months post-Implanon removal and persistent galactorrhea for four years, even after breastfeeding cessation.
• Initial investigations, including imaging, were conducted to identify the cause of her symptoms.

Findings:

• Despite extensive workup ruling out common physiological and pathological causes, the hyperprolactinemia was deemed idiopathic.
• The patient's condition presented diagnostic challenges in primary care due to the unclear etiology.

Implications:

• This case underscores the importance of considering idiopathic hyperprolactinemia, even when symptoms are persistent.
• Successful management with adequate treatment led to the resolution of menstrual irregularities and galactorrhea, demonstrating treatment efficacy.