Hyperprolactinemia

causes:

• Prolactinoma

woman with infertility, amenorrhoea, galactorrhoea (usually microadenomas in females so no pressure symptoms)

Man with visual field deficit, headaches etc (usually macroadenoma in males so there r pressure symptoms)

• Primary hypothyroidism

Increased TRH stimulates excess prolactin production

• Drugs:

Dopamine antagonists (antipsychotics), SSRIs, TCAs, methyldopa, metochlopromide
Dopamine inhibits prolactin secretion so its antagonists remove this inhibitory effect

Tmt:

First line for all patients: Bromocriptine

Men with prolactinomas(macroadenoma) : surgery or radio

Old women with microadenoma , not concerned about fertility, : no treatment reqrd.