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Kondreddy Naveen at 18:04, 2 February 2024

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== Galactorrhea hyperprolactinemia ==

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'''Galactorrhea hyperprolactinemia''' is increased blood [[prolactin]] levels associated with [[galactorrhea]] (abnormal milk secretion). It may be caused by such things as certain [[medication]]s, [[pituitary disorder]]s and [[thyroid]] disorders. The condition can occur in males as well as females. Relatively common etiologies include [[prolactinoma]], medication effect, [[kidney failure]], [[granulomatous disease]]s of the [[pituitary gland]], and disorders which interfere with the hypothalamic inhibition of prolactin release. [[Ectopic expression|Ectopic]] (non-pituitary) production of prolactin may also occur. Galactorrhea hyperprolactinemia is listed as a “[[rare disease]]” by the [[Office of Rare Diseases]] of the [[National Institutes of Health]]. This means that it affects less than 200,000 people in the [[United States]] population.<ref name="wrongdiagnosis1">{{cite web|url=http://www.wrongdiagnosis.com/g/galactorrhoea_hyperprolactinaemia/basics.htm |title=What is Galactorrhoea-Hyperprolactinaemia? - RightDiagnosis.com |publisher=Wrongdiagnosis.com |date=2015-04-17 |accessdate=2015-07-09}}</ref>

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==Signs and symptoms==
Symptoms of galactorrhea hyperprolactinemia include a high blood prolactin level, abnormal milk production in the [[breast]], galactorrhea, [[Menstruation|menstrual]] abnormalities, reduced [[libido]], reduced [[fertility]], [[puberty]] problems, and [[headache]]s.<ref name="wrongdiagnosis1"/>
==Causes==
The following are some of the possible medical causes of galactorrhea hyperprolactinemia that are listed by the [[Diseases Database]]: pregnancy, [[breastfeeding]], [[sexual intercourse]], [[shingles]], prolactin secreting [[pituitary tumor]], along with many others.<ref name="wrongdiagnosis1"/>

==Diagnosis==
Galactorrhea is generally considered a [[symptom]] which may indicate a more serious problem. Collection of a thorough [[medical history]], including [[Pregnancy|pregnancies]], surgeries, and consumption of [[drug]]s and medications is a first step in diagnosing the cause of galactorrhea. A [[physical examination]], along with a [[breast examination]], will usually be conducted. [[Blood]] and [[urine]] samples may be taken to determine levels of various [[hormone]]s in the body, including prolactin and compounds related to thyroid function. A [[mammogram]] (an [[X-ray]] of the breast) or an [[ultrasound scan]] (using high frequency sound waves) might be used to determine if there are any [[tumor]]s or [[cyst]]s present in the breasts themselves. If a tumor of the pituitary gland is suspected, a [[magnetic resonance imaging]] (MRI) scan can locate tumors or abnormalities in tissues.<ref>{{cite web |url=http://www.pregnancy.org/question/what-galactorrhea |title=What is Galactorrhea? |publisher=Pregnancy.org |date= |accessdate=2015-07-09 |archive-url=https://web.archive.org/web/20150710161908/http://www.pregnancy.org/question/what-galactorrhea |archive-date=2015-07-10 |url-status=dead }}</ref>

==Treatment==
===Medical care===
Direct treatment is geared toward resolving hyperprolactinemic symptoms or reducing tumor size. Patients on medications that cause [[hyperprolactinaemia]] should have them withdrawn if possible. Patients with [[hypothyroidism]] should be given thyroid [[hormone replacement therapy]]. When symptoms are present, [[medical therapy]] is the treatment of choice. Patients with hyperprolactinemia and no symptoms (idiopathic or microprolactinoma) can be monitored without treatment. Consider treatment for women with [[amenorrhea]]. In addition, [[dual energy X-ray absorptiometry]] scanning should be considered to evaluate [[bone density]]. The persistent [[hypogonadism]] associated with hyperprolactinemia can lead to [[osteoporosis]]. Treatment significantly improves the patient's quality of life. If the goal is to treat hypogonadism only, patients with [[idiopathic]] hyperprolactinemia or [[microadenoma]] can be treated with [[estrogen replacement therapy]] and prolactin levels can be monitored. [[Radiation treatment]] is another option. However, the risk of [[hypopituitarism]] makes this a poor choice. It may be necessary for rapidly growing tumors, but its benefits in routine treatment have not been shown to outweigh the risks.{{citation needed|date=August 2020}}

===Surgical care===
General indications for pituitary surgery include patient [[drug intolerance]], tumors resistant to medical therapy, patients who have persistent [[visual field]] defects in spite of medical treatment, and patients with large cystic or hemorrhagic tumors.{{citation needed|date=August 2020}}

===Consultations===
Physicians who are comfortable with the initial evaluation of a patient (without evidence of tumor [[Mass effect (medicine)|mass effect]]) can easily initiate therapy and provide follow-up. However, given the time constraints of modern [[ambulatory medicine]], consultation with an [[endocrinologist]] is often necessary.<ref>{{EMedicine|article|121784|Hyperprolactinemia|treatment}}</ref>
==Prognosis==
The prognosis for patients with prolactinomas is good: most remain stable or regress. In pregnant women, prolactinomas must be observed closely because the lesions may greatly increase in size.<ref>{{cite journal|url=http://www.aafp.org/afp/2001/0501/p1763.html |title=Evaluation and Treatment of Galactorrhea |journal=American Family Physician |volume=63 |issue=9 |pages=1763–70 |date=2001-05-01 |accessdate=2015-07-09|last1=Rosenfeld |first1=Jo Ann |last2=Pena |first2=Kristin S. |pmid=11352287 }}</ref>

==Epidemiology==
Hyperprolactinemia occurs more commonly in women. The prevalence of hyperprolactinemia ranges from 0.4% in an unselected normal adult population (10,000 normal [[Japan]]ese adults working at a single factory) to as high as 9 to 17% in women with [[reproductive disorder]]s. Its prevalence was found to be 5% in a [[family planning clinic]] population, 9% in a population of women with adult-onset amenorrhea, and 17% among women with [[polycystic ovary syndrome]].<ref>{{cite web|url=http://www.medscape.com/viewarticle/447780_2 |title=Hyperprolactinemia: Etiology, Diagnosis, and Management |publisher=Medscape.com |date= |accessdate=2015-07-09}}</ref>

==References==
{{Reflist}}

[[Category:Endocrine diseases]]
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Galactorrhea hyperprolactinemia - Revision history

Prab at 19:14, 19 March 2025

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Kondreddy Naveen at 18:04, 2 February 2024