Normal prolactin values are between 1.61-18.77ng/ml
I. Physiological hyperprolactinemia
(i) Nocturnal and sleep (2-6Am).
(ii) Late ovulation and luteal phase.
(iii) Pregnancy: ≥10-fold higher than during non-pregnancy.
(D) Lactation: acute, short-term or continuous increase in secretion caused by massage, nipple sucking.
(E) puerperium: 3~4 weeks.
(F) hypoglycemia.
(vii) exercise and stress stimulation.
(H) sexual intercourse: markedly elevated during orgasm.
(ix) Fetal and neonatal (≥ 28 gestational weeks ~ 2~3 weeks postpartum).
II. Pathological hyperprolactinemia
(a) Hypothalamic-pituitary lesions
1, tumor: non-functional – craniopharyngioma, sarcomatoid disease glioblastoma; functional – PRL adenoma 46%; GH adenoma 22-31%; PRL-GH adenoma 5-7%; ACTH adenoma 15%. Multifunctional adenoma 10%; undifferentiated tumor 19~27%.
2, inflammation: skull base meningitis, tuberculosis, syphilis, actinomycosis.
3.Destruction: injury, surgery, arteriovenous malformation, sarcoidosis.
4.Hollow vesicle saddle syndrome.
5.Pituitary stalk lesion, injury or tumor compression.
6.Mental trauma and stress.
7, Parkinson’s disease.
(B) primary and/or secondary hypothyroidism.
1, pseudohypoparathyroidism.
2, Hashimoto’s thyroiditis.
(C) Ectopic PRL-secreting syndrome: undifferentiated bronchopulmonary carcinoma, adrenal carcinoma, embryonal carcinoma.
(D) adrenal and renal disease: Addison’s disease, chronic renal failure.
(E) polycystic ovary syndrome.
(F) cirrhosis of the liver.
(G) obstetrical and gynecological surgery: abortion, induction of labor, stillbirth, hysterectomy, tubal ligation, ovariectomy.
(H) local irritation: papillitis, chafing, chest wall trauma, herpes zoster, tuberculosis, surgery.
(ix) Medical-pharmacological factors:
1, insulin hypoglycemia.
2, sex hormones (estrogen-progestin birth control pills).
3, synthetic TSH-RH.
4, anesthetics: morphine, methadone, methionine enkephalin.
5.Dopamine receptor blocking