Prolactin is a hormone synthesized and secreted by the anterior pituitary gland, and its main role in the physiological state is to promote the growth and development of mammary secretory tissue, initiate and maintain lactation, and in men it also has the role of promoting the growth of prostate and seminal vesicles. However, long-term chronic hyperprolactinemia can lead to suppression of ovarian function, ovulation disorders, menstrual disorders, amenorrhea and lactation; in men, it causes low sexual function, reduced spermatogenesis, impotence and infertility, obesity and osteoporosis. In addition, if the tumor grows significantly, it may cause a series of similar problems of saddle area tumor, please refer to my other articles for the danger.
Causes of increased prolactin.
1.Physiological increase: such as overwork, mental stress, hypoglycemia, lactation, etc. Characteristically, the increase is not large, and will recover after the cause is lifted, and generally does not cause pathological symptoms.
2, drug-increased: some drugs can cause increased prolactin, but generally below 100ng/ml, and can be relieved after stopping the drug.
3, idiopathic increase: the cause is unknown, hypothalamic pituitary dysfunction is more likely, mild increase can be observed.
4, pathological increase: hypothalamic or pituitary stalk lesions, causing insufficient secretion of hypothalamic prolactin inhibitory factor or blockage of downward transport pathways.
(1) low thyroid function.
(2) some chest wall or breast diseases.
(3) chronic renal failure.
(4) gynecologic surgery.
(5) pituitary prolactin adenoma adenoma, mixed pituitary adenoma, or some other body site tumor secretion.
Treatment recommendations.
Drugs: bromocriptine reversible to shrink the tumor, inhibit the growth of tumor cells, fibrosis after long-term treatment, after stopping the drug will cause the tumor to resume growth, so it requires long-term or even lifelong medication, only a few cases can achieve a cure. Its adverse effects are mainly reactions such as nausea dizziness and vomiting.
Surgical treatment.
1.Ineffective drugs.
2.Inability to tolerate drugs.
3.Tumor shrinkage is not obvious after taking drugs for giant adenoma, and the compression symptoms are not released.
4.Invasive appearance of nasal leakage.
It should be noted that if there is a tumor stroke, surgery is recommended as the first choice. If surgery is chosen after long-term administration of bromocriptine, the cure rate of surgery may be reduced due to tumor fibrosis and other reasons.
Radiotherapy is not recommended as the first choice of treatment.
Pregnancy in patients with pituitary prolactin adenoma
If drug therapy is used, regular menstruation, normal prolactin and gynecologic examination should be followed by ovulation, and pregnancy should be discontinued under medical supervision. For pituitary prolactin macroadenoma, pregnancy after surgery is recommended.