Hyperprolactinemia: Symptoms for different groups of people
Hyperprolactinemia is the increased content of the prolactin hormone in the blood. Physiological hyperperprolactinemia in women occurs during pregnancy or during lactation. But this condition can occur without pregnancy, both in women and men. The main feature is the allocation of milk or colostrum from the mammary glands.
The hormone prolactin plays an important role in the hormonal system, and if its amount rises, simultaneously there is no menstruation or amenorrhea. That is why in the early postpartum period( during breastfeeding), for several months, women do not have menstruation, and this condition is not pathological.
In the case of hyperprolactinemia, the causes are diverse and are divided into the following groups:
- Diseases in which the hypothalamus is abnormal. These include benign or malignant tumors, infectious diseases( meningitis, encephalitis, tuberculosis), as well as various traumas of the hypothalamus.
- Diseases in which a pituitary dysfunction occurs. These include micro- and macro-tumors of various etiologies, as well as the "empty Turkish saddle" syndrome, when on the roentgenogram I detect dystrophic-degenerative changes in the pituitary gland.
- Other diseases associated with the endocrine system. These include hypothyroidism, ovarian polycysticosis, liver cirrhosis and chronic hepatitis, shingles, chronic renal failure.
- Some medications that can cause changes in the endocrine system( oral contraceptives, opiates, cocaine, estrogens, antiemetics, antidepressants).
Symptoms of hyperprolactinemia
With the established diagnosis of hyperprolactinaemia, symptoms can begin suddenly, and sometimes gradually. The clinical picture of the disease is characterized mainly by the symptom of the separation of milk from the breast.
Syndrome giperprolaktinemii in women is also accompanied by a violation of menstrual function, and in men there is a decrease in craving and potency. Lactorrhea can be insignificant, in the form of a few drops, as well as spontaneous, when the milk constantly flows from the nipple. Usually the character of the discharge from the chest is marked with the sign "+", from one to several.
Sometimes the only symptom of hyperprolactinemia is a malfunction in normal menstrual function. The abnormalities may be as follows:
- Shortening of the luteal phase, in which biphasic uterine bleeding is observed.
- Opposomenorrhoea, when uterine bleeding continues for 30 days or more.
- Oligomenorrhoea, in which there are scanty monthly.
- Amenorrhea, which is characterized by a complete absence of menstruation.
- Metrorrhagia, which is characterized by heavy bleeding and requires emergency therapy.
Hyperprolactinemia in women may be accompanied by an increase in body weight, in which fluid retention occurs in the body, as well as with osteoporosis. Symptoms of hyperprolactinemia include acne on the face, various spots appear, and hairiness changes( according to the male type).This is because the increased content of the hormone prolactin entails an increase in androgens - male sex hormones.
Hyperprolactinaemia in men manifests itself in the form of decreased desire, and many men note a sharp decrease in erectile function. If the disease progresses, impotence may occur. At first, many men do not pay attention to the decrease in potency, as they associate this with multiple psychogenic factors.
Sometimes, in such cases, neurologists put men diagnosed as "psychogenic impotence."This can be a diagnostic error, since for differential diagnosis with hyperprolactinemia it is necessary to check the level of prolactin in the blood.
Very often hyperprolactinemia in men occurs against the background of taking anabolic steroid drugs. Then, in addition to the allocation of milk from the breast, symptoms such as gynecomastia( breast enlargement according to the female type) and a decrease in the testes are added, followed by their softening. Men also have severe osteoporosis, headaches, visual impairment( loss of visual fields and reduced acuity).
In some cases it happens that men go for a long time to doctors sex therapists, urologists and oculists, trying to find out the cause of this pathological condition. Therefore, the diagnosis of men is made later than in women, which leads to gynecologists, mainly a violation of menstrual function.
In the case of diseases of the endocrine system, the signs of hyperprolactinemia are manifested in the form of dry mouth, weakness, tachycardia, excessive sweating, irritability, tearfulness.
Much worse is the picture of the disease, if the cause is different tumors of the hypothalamus and pituitary gland. There are signs of hyperprolactinaemia, such as loss of visual fields, painful headaches, leakage of cerebrospinal fluid from the nose, paresis and paralysis. The psychoemotional status of such patients is severely impaired, depression, sleep disturbance, and memory loss appear.