Chapter-049 Disorders of Prolactin Excess

BOOK TITLE: ESI Manual of Clinical Endocrinology

1. George Belinda
2. Bantwal Ganapathy
Publishing Year
Author Affiliations
1. St John’s Medical College and Hospital, Bengaluru, Karnataka, India, St. Johns Medical College Hospital, Bangalore, Karnataka, India, St John’s National Academy of Health Sciences, Bengaluru, Karnataka, India
2. St. Johns Medical College, Bengaluru, Karnataka, India
Chapter keywords
Prolactin, hyperprolactinemia, neuroleptics, prolactinomas, radiotherapy, malignant prolactinoma


Prolactin is a hormone secreted by pituitary lactotrophs and helps to induce and maintain lactation of the primed breast. Hyperprolactinemia is observed in women with secondary amenorrhea and galactorrhea. The causes of hyperprolactinemia are divided into physiological, pharmacological, and pathological categories. Different types drugs and chemical agents such as neuroleptics, antipsychotics, and gastrointestinal medications etc., cause hyperprolactinemia. Prolactinomas are secretory pituitary adenomas and responsible for all pituitary tumors. Prolactinomas are categorized on the basis of size such as microadenomas, macroadenomas, and giant prolactinomas. Clinical features of hyperprolactinemia include women with classic amenorrhea–galactorrhea syndrome or infertility, sexual dysfunction in men, low sperm count with oligoasthenospermia and increased incidence of osteopenia and osteoporosis etc. Various diagnostic factors of prolactinoma and various medical treatment of prolactinoma such as dopamine agonists etc. are also have their detail. Surgical interventions are used for those cases which do not respond to medical therapy due to intolerance or resistance. In addition the radiotherapy, patient follow-up and special situations like pregnancy and prolactinoma, malignant prolactinoma are also thoroughly discussed.

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