Hyperprolactinemia,

Hyperprolactinemia, is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • In women, the most common causes of pathologic hyperprolactinemia are prolactin-
secreting pituitary microadenomas and idiopathic hyperprolactinemia (Table 24-3).
    Table 24-3: Major Causes of Hyperprolactinemia
    Pregnancy and Lactation
    Prolactin-secreting pituitary adenoma (prolactinoma)
    Idiopathic hyperprolactinemia
    Drugs (e.g., phenothiazines, atypical antipsychotic medications, metoclopramide, verapamil)
    Interference with synthesis or transport of hypothalamic dopamine
    Hypothalamic lesions
    Nonsecretory pituitary macroadenomas
    Primary hypothyroidism
    Chronic renal failure
  • In men, the most common cause is a prolactin-secreting macroadenoma.
  • Hypothalamic or pituitary lesions that cause deficiency of other pituitary hormones often cause hyperprolactinemia.
  • Medications are an important cause in both men and women.

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General Principles

  • In women, the most common causes of pathologic hyperprolactinemia are prolactin-
secreting pituitary microadenomas and idiopathic hyperprolactinemia (Table 24-3).
    Table 24-3: Major Causes of Hyperprolactinemia
    Pregnancy and Lactation
    Prolactin-secreting pituitary adenoma (prolactinoma)
    Idiopathic hyperprolactinemia
    Drugs (e.g., phenothiazines, atypical antipsychotic medications, metoclopramide, verapamil)
    Interference with synthesis or transport of hypothalamic dopamine
    Hypothalamic lesions
    Nonsecretory pituitary macroadenomas
    Primary hypothyroidism
    Chronic renal failure
  • In men, the most common cause is a prolactin-secreting macroadenoma.
  • Hypothalamic or pituitary lesions that cause deficiency of other pituitary hormones often cause hyperprolactinemia.
  • Medications are an important cause in both men and women.

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