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Hyperprolactinemia
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of hyperprolactinemia are prepared by our editorial team based on guidelines from the European Society of Endocrinology (ESE 2021), the European Thyroid Association (ETA 2018), and the Endocrine Society (ES 2011).
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Screening and diagnosis
Diagnosis: as per ES 2011 guidelines, obtain a single measurement of serum prolactin for the diagnosis of hyperprolactinemia and confirm the diagnosis with a level above the ULN as long as the serum sample is obtained without excessive venipuncture stress.
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Differential diagnosis
Diagnostic investigations
Serum prolactin levels: as per ES 2011 guidelines, obtain a single measurement of serum prolactin for the diagnosis of hyperprolactinemia.
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Screening for central hypothyroidism
Medical management
Dopamine agonists: as per ES 2011 guidelines, initiate dopamine agonist therapy to lower prolactin levels, decrease tumor size, and restore gonadal function in patients with symptomatic prolactin-secreting microadenomas or macroadenomas.
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Oral contraceptives
Therapeutic procedures
Surgical interventions
Specific circumstances
Patients contemplating pregnancy: as per ESE 2021 guidelines, manage female patients of reproductive age contemplating pregnancy with a diagnosis of pituitary adenoma, functioning or nonfunctioning, by an endocrinologist.
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Pregnant patients (monitoring)
Pregnant patients (management)
Pregnant patients (delivery and breastfeeding)
Patients with drug-induced hyperprolactinemia
Patients with malignant prolactinoma