Management of borderline hyperprolactinemia

Progressively increasing plasma prolactin (PRL) concentrations are currently associated with menstrual disturbances, anovulation and cessation of cyclic activity. Galactorrhea-amenorrhea in the presence of normal plasma PRL is rare, but the favorable response to bromocriptine confirms its lactogen dependency. The concept of "transient hyperprolactinemia' is analyzed and alternative explanations for the positive results of dopamine agonist therapy in this particular condition are proposed. Moderate hyperprolactinemia can be associated with luteal inadequacy and infertility. Inhibition of PRL secretion with bromocriptine can normalize luteal function and restore the ability to conceive.