Hyperprolactinemia syndrome in women: diagnosis and correction

Abstract

The article is devoted to modern views on the diagnosis and treatment of hyperprolactinemia syndrome in women. Prolactinomas are the leading cause of hyperprolactinemia syndrome. The main clinical manifestations of a pathological increase in the level of prolactin are hypogonadism and galactorrhea, in some cases there are neurological symptoms, as well as psycho-emotional and asthenovegetative disorders. The publication reviews management tactics of patients with prolactinomas and pathological conditions secondary to elevated prolactin levels. Both conservative approaches to the correction of hyperprolactinemia and surgical treatment methods are described. It is noted that at present, drug therapy has priority over surgery. In the medical treatment of hyperprolactinemia, dopamine receptor agonists are used. The duration of therapy with this group of drugs is at least 2 years. The targets should be long-term normalisation of prolactin levels and a significant reduction in the size of the tumour or its absence according to the results of magnetic resonance imaging of the brain. Women with drug-resistant prolactinomas are advised to increase the dose of dopamine receptor agonists to the maximum tolerated dose before considering surgical intervention. Special attention is paid to the management of patients whose pregnancy occurred amid a pathological increase in the level of prolactin. In addition, methods for correcting drug-induced hyperprolactinemia are considered. The long list of drugs that can cause increased prolactin levels shows that the problem of hyperprolactinemia may be encountered by doctors of various specialties. The data presented in the publication are based on clinical guidelines approved by the Russian Ministry of Health and comply with the principles of evidence-based medicine.

Keywords

amenorrhea / dopamine receptor agonists / galactorrhea / hypogonadism / infertility / micro- and macroprolactinomas / prolactin / syndrome of hyperprolactinemia in women

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