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Hyperprolactinemia is an abnormal elevation in the serum prolactin level with multiple possible etiologies.

• Predominant age: Reproductive age
• Predominant sex: Female > Male.
• More readily detected in females because a slight elevation in prolactin causes changes in menstruation and galactorrhea

• Prolactin, which is produced by lactotrophs in the anterior pituitary, is regulated by
  • Inhibitory factors, primarily dopamine, produced in the hypothalamus and delivered via the hypothalamic-pituitary vessels in the pituitary stalk
  • Stimulatory factors, primarily thyrotropin-releasing hormone (TRH)
• Causes of hyperprolactinemia include
  • Physiologic:
    • Pregnancy
    • Breast-feeding
    • Nipple stimulation
    • Stress, including postoperative state
  • Medications:
    • Dopamine (D₂) blockers: Antipsychotics, metoclopramide
    • Dopamine depleters: α-methyldopa, reserpine
    • Opiates
    • Verapamil (but no other calcium-channel blockers; thought to decrease ...

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