Hcer Dx diferencial. Valoración general: Antecedentes del edo. menstrual, embarazos, fertilidad, así como uso de fármacos y otros síntomas. La hiperprolactinemia es un motivo de consulta frecuente en la práctica diaria. frecuentes son la oligomenorrea/amenorrea, la galactorrea y la infertilidad. A hiperprolactinemia causa hipogonadismo, irregularidade menstrual ou menstrual irregularities or amenorrhea in women, low serum testosterone levels in colecistoquinina, bombesina, neurotensina, neuropeptídeo Y. Outros fatores .

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Hyperprolactinemia can be physiological or pathological. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas.

Diagnosis and treatment of hyperprolactinemia: However, presence of a pituitary macroadenoma may require surgical or radiological management. J Clin Endocrinol Metab. Dopamine agonists and pituitary tumor shrinkage.

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In the remaining women, exogenous gonadotropin stimulation can be added along with dopamine agonist to achieve ovulation.

National Center for Biotechnology InformationU. Abstract Prolactin PRL is an anterior pituitary hormone which has its principle physiological action in initiation and maintenance of lactation. During lactation and breastfeeding, ovulation may be suppressed due to the suppression of gonadotropins by prolactin, but may resume before menstruation resumes. Though both drugs have been found to be safe in pregnancy, the number of reports studying bromocriptine in pregnancy far exceeds that of cabergoline.

In the cases of microprolactinomas and intrasselar macroprolactinomas, the treatment with dopaminergic agonists may be suspended after pregnancy is confirmed. Anovulation, galactorrhea, hyperprolactinemia, prolactin, prolactinomas.


View All Subscription Options. Initially it was thought that patients would require lifelong dopamine agonist therapy but the current use has evolved into a dynamic process depending on the patient’s requirement. This is because galactorrhea requires adequate estrogenic or progesterone priming of breast.

Prolactin and human tumourogenesis.

This may be due to hydrolysis of the lysergic acid part of the molecule. There are several possible explanations for the recurrence or persistence of hyperprolactinemia after surgery as listed below:. Outcomes of transsphenoidal surgery in prolactinomas: Kluwer Academic Publishers; The main biological action of prolactin is inducing and maintaining lactation. Etiology of hyperprolactinemia[ 11 ]. Macroprolactinomas usually present with neurological symptoms caused by mass effects of the tumor.

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However, molecular biology studies indicate that pituitary tumors are monoclonal in origin. Initially, even though this hormone was recognized in relation to lactation in women, lately immense interest has been focused on prolactin with respect to its effect on reproduction.

It exercises hiperprolacttinemia by a counter-current flow in the hypophyseal pituitary portal system which initiates secretion of hypothalamic dopamine, as well as causes inhibition of pulsatile secretion of gonadotropin releasing hormone GnRH. Prolactinomas are usually classified as microprolactinomas less amenoreea 1 cm or macroprolactinomas larger than 1 cmwhich can either be confined or invasive.

A new complication of the ergot derivative dopamine agonists. Unlike other tropic hormones secreted by the anterior pituitary gland, prolactin secretion is controlled primarily by inhibition from the hypothalamus and it is not subject to negative feedback directly or indirectly by peripheral hormones. Advances in the treatment of prolactinomas. This negatively modulates the secretion of pituitary hormones responsible for gonadal function.


There are several possible explanations for the recurrence or persistence of hyperprolactinemia after surgery as listed below: Clinical presentation of hyperprolactinemia. Galactorrhea, a typical symptom of hyperprolactinemia, occurs in less than half the cases. Services on Demand Journal.


Melmed S, Jameson JL. In women with hyperprolactinemic amenorrhea one important consequence of estrogen deficiency is osteoporosis, which deserves specific hiperprolactinenia consideration.

Resistance to cabergoline as compared with bromocriptine in hyperprolactinemia: Structure, function, and regulation of secretion. Prolonged hypoestrogenism secondary to hyperprolactinemia may result in osteopenia. Physiological hyperprolactinemia is usually mild or moderate.

Some of the common hiperprolactihemia are listed in Figure 1. Many commercial assays do not detect macroprolactin. External radiation therapy is only reserved for residual tumor in patients who have undergone surgery and the entire tumor is not removed.

However, hormone replacement therapy HRT to replenish estrogen deficit should be given to all patients with amenorrhea.