Hyperprolactinemia in reproductive-aged women: what should a physician remember

Andreeva E.N., Sheremetyeva E.V., Grigoryan O.R.

1) National Medical Research Center of Endocrinology, Ministry of Health of the Russian Federation, Moscow, Russia; 2) A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation, Moscow, Russia
In recent years, interest has been expressed by different physician specialties in diseases and syndromes associated with impaired prolactin (PRL) secretion. According to the Russian clinical practice guidelines, the hyperprolactinemic syndrome is a symptom complex that occurs in the presence of hyperprolactinemia, the most characteristic manifestation of which is dysfunction of the reproductive tract. The prevalence of pathological hyperprolactinemia in reproductive-aged women is 5%. At their visit to an obstetrician/gynecologist, one third of women complain about various menstrual cycle abnormalities, which may be associated, among other things, with higher prolactin levels. According to statistics, hyperprolactinemia occurs in 9% of reproductive-aged women with amenorrhea and in 17% of those with polycystic ovary syndrome. Hyperprolactinemia may be of physiological origin. Hyperprolactinemia can be a combined clinical manifestation of a number of different pathological conditions of the reproductive tract in young women. In reproductive-aged women, about 70% of menstrual irregularities can be concurrent with hyperprolactinemia due to stress and distress, surgical treatment for gynecological and non-gynecological diseases, oral hormonal contraception, and use of psychotropic drugs from a group of neuroleptics and antidepressants. This paper considers the common reasons for higher prolactin, the basics and errors of diagnosis, and the basic principles of treatment and follow-up in reproductive-aged patients with hyperprolactinemia. There is much evidence that it is necessary to work within the framework of personalized medicine, and this is not only the efficiency of a chosen treatment regimen, but also primarily safety, especially if the same holds true for reproductive-aged women who can potentially get pregnant.
Conclusion: Cabergoline is recommended as a first-line drug, being most effective, to normalize prolactin levels and to reduce tumor size. The 2021 study has shown that cabergoline is not only an effective, but also the safest drug to relieve hyperprolactinemia.




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Received 07.09.2021

Accepted 13.09.2021

About the Authors

Elena N. Andreeva, Dr. Med. Sci., Professor, Deputy Director of the Center – Director of the Institute of Reproductive Medicine, Head of the Department of Endocrine Gynecology, Professor of the Department of Endocrinology, National Medical Research Center of Endocrinology, Ministry of Health of the Russian Federation; Professor of the Department of Reproductive Medicine and Surgery, A.I. Evdokimov Moscow State Medical and Dental University, Ministry of Health of the Russian Federation,
endogin@mail.ru, https://orcid.org/0000-0001-8425-0020, eLibrary SPIN: 1239-2937, 117036, Russia, Moscow, Dmitry Ulyanov str. 11.
Ekaterina V. Sheremetyeva, PhD, Leading Researcher of the Department of Endocrine Gynecology, National Medical Research Center of Endocrinology of the Ministry of Health of the Russian Federation, s1981k@yandex.ru, https://orcid.org/0000-0001-7177-0254, eLibrary SPIN: 9413-5136, 117036, Russia, Moscow, Dmitry Ulyanov str. 11.
Оlga R. Grigoryan, Dr. Med. Sci., Chief Scientific Researcher, National Medical Research Center of Endocrinology of the Ministry of Health of the Russian Federation, iceberg1995@mail.ru, http://orcid.org/0000-0003-4979-7420, eLibrary SPIN: 3060-8242, 117036, Russia, Moscow, Dmitry Ulyanov str. 11.
Corresponding author: Ekaterina V. Sheremetyeva, s1981k@yandex.ru

Authors' contributions: Andreeva E.N. – concept and design of the investigation; editing; Sheremetyeva E.V. – material collection and processing; Sheremetyeva E.V., Grigoryan O.R. – writing the text. All the authors have approved the final version of the article before its publication, agreed to be responsible for all aspects of the investigation that implies a proper study and resolution of the issues related to the accuracy or bona fides of any part of the work.
Conflicts of interest: The authors declare that there are no manifest and potential conflicts of interest, which are related to the contents of this article.
Funding: This article has been written without sponsorship.

For citation: Andreeva E.N., Sheremetyeva E.V., Grigoryan O.R. Hyperprolactinemia in reproductive-aged women: what should a physician remember.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 9: 204-210 (in Russian)

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