This document discusses hyperprolactinemia, including its causes, clinical manifestations, diagnosis, and treatment. Prolactin is a hormone produced by the pituitary gland that regulates lactation. Hyperprolactinemia can be caused by physiological conditions like pregnancy or pathological conditions like pituitary adenomas. Common symptoms include galactorrhea, infertility, and menstrual irregularities. Diagnosis involves measuring prolactin levels and imaging tests. Treatment focuses on addressing the underlying cause, such as using dopamine agonists to reduce prolactin levels or surgery to remove pituitary tumors.
10. A- Inhibition of pulsatile GnRH secretion
1- Hyperprolactinemia inhibit GnRH activity by
interacting with hypothalamic DA and opioid
system via the short-loop feedback mechanism.
16. – Sleep
– Satiety
– Stress&Exercise
– Sex
– Second half Menstrual cycle(luteal phase)
– Suckling
If a woman's prolactin level is elevated the first time it is tested,
a second sample should be checked when she is fasting and
non-stressed.
Physiologic conditions
20. 2. Hypothalamic:
• * A craniopharyngioma is a benign tumor that
develops near the pituitary gland inhibits PIF
(dopamine) secretion or access to pituitary.
• Emty sella syndrome
*Organic lesion: trauma, infection, tumors
.
• * Psychological disturbance.
21. Diagrammatic representation of empty sella syndrome.
A, Normal anatomic relationship.
B, C, and D, Progression in development of empty sella syndrome.
Note thinning of floor and symmetric enlargement of sella turcica.
Empty sella sydrome
37. 3- Trans-sphenoid surgery:
• For Pituitary adenoma only if :
• - No response to medical ttt.
• - Causing visual field defect.
• - TTT is not tolerable.