Sometimes, some women find that they are not pregnant and only after testing do they find out that they have hyperprolactinemia. Prolactin is a hormone secreted by the pituitary gland. Normally, during non-lactation, prolactin is kept at a very low level and non-lactating women do not experience lactation or overflow. We know that the main function of prolactin (PRL) is to promote lactation. It increases from the 7th week of gestation and gradually increases as pregnancy progresses, reaching a peak of about 200 μg/L before delivery at full term, which is 20 times more than 10 μg/L in non-pregnant women. Hyperprolactinemia is a problem that occurs in the pituitary plane People may not be aware that our women’s menstruation is affected by many factors, most notably the hypothalamic-pituitary-ovarian axis, and problems at any level can lead to amenorrhea or menstrual irregularities. Hyperprolactinemia is when a problem occurs in the pituitary plane. All types of glandular cells in the anterior pituitary gland that proliferate have the potential to become various types of hypersecretory pituitary adenomas. Commonly, prolactin cells proliferate and secrete excessive amounts of prolactin (PRL), causing the amenorrhea-lactation syndrome of pituitary prolactin adenoma. Amenorrhea and lactation may be due to hyperprolactinemia If a woman with a normal menstrual cycle has not had a menstrual cycle for 3 months or has not had a menstrual period for 6 months for unknown reasons, accompanied by lactation or overflow, it is important to go to an obstetrics and gynecology or endocrinology department for an examination to rule out hyperprolactinemia. (1) Generally, your doctor will take a careful medical history (including menstrual history and childbirth history), perform a physical examination and gynecological examination, and draw blood for sex hormone levels and prolactin levels. (2) If elevated levels of the latter are found, you will also be advised to undergo cranial imaging to help diagnose the presence of a pituitary tumor. In the event of a pituitary tumor, you will also be asked to go to an ophthalmologist for a visual field examination. In summary, many tests are needed to diagnose hyperprolactinemia, and only then can a better decision be made about how to treat it. Infertility can also be caused by hyperprolactinemia. Sometimes women find out that they are not pregnant and only after testing do they find out that they have hyperprolactinemia. This is because when blood prolactin levels are elevated, it affects ovarian function and can lead to amenorrhea and breast overflow. Therefore, pituitary tumors and hyperprolactinemia mentioned above are among the causes of female infertility. This disease is not very scary and there are good treatment methods available. They include conservative medication and surgical treatment, etc. (1) Most patients can be treated with medication, and the drug of choice is bromocriptine. Bromocriptine is a dopamine agonist, which binds to dopamine receptors and can inhibit the synthesis and secretion of prolactin (PRL) and shrink tumors. It is administered at 2.5-5 mg/day. Women taking bromocriptine medication should have their prolactin levels measured regularly to observe the efficacy of the treatment. When preparing to become pregnant, consult your endocrinologist if you can stop the medication. Sometimes bromocriptine may be taken at the same time during pregnancy, but it is important to follow your doctor’s orders. (2) Pituitary macroadenoma with significant symptoms may also require surgery. (3) During pregnancy, the pituitary gland will be strengthened and become more active in secretion. At this time, it is also important to pay attention to the re-emergence or aggravation of some of the original symptoms, such as lactation, headache, and changes in visual field, so further diagnosis and treatment are needed. Prolactin may also increase after pregnancy Prolactin may increase after pregnancy because the placenta can also secrete a certain amount of human placental prolactin (HPL), which varies with the progress of the pregnancy week. However, when an abnormally high level of prolactin (PRL) is found, it can still have an effect on pregnancy, causing adverse outcomes such as miscarriage, in addition to not being able to conceive easily. Special Note It is worth reminding that there are also many other causes of amenorrhea that need to be identified. In case of nipple overflow, it is also necessary to go to breast surgery to exclude the possibility of breast tumor.