Treatment for<unk>  is usually dependent upon its cause, ranging from hypothyroidism, drug-induced<unk> , hypothalamic disease, idiopathic<unk> , macroprolactin, or prolactinoma. Therefore, in order to provide the proper management of<unk> , the pathological form and physiological increase in prolactin levels are differentiated, and the correct cause of<unk>  must be identified before treatment. For functional asymptomatic<unk> , the treatment of choice is removing the associated cause, including antipsychotic therapy. However, prolactin levels should be drawn and monitored both prior to any discontinuation or changes to therapy, and afterwards. With symptomatic<unk> , stopping antipsychotic drugs for a short trial period are not recommended due to the risk of exacerbation or relapse of symptoms. Options for treatment include decreasing the dose of antipsychotics, adding aripiprazole as an adjunctive therapy, and switching antipsychotics as a last resort. In pharmacologic<unk> , the concerning drug can be switched to another treatment or discontinued entirely. Vitex agnus-castus extract may be tried in cases of mild<unk> . No treatment is required in asymptomatic macroprolactin and instead, serial prolactin measurements and pituitary imaging is monitored in a regular follow-up appointments. Medical therapy is the preferred treatment in prolactinomas. In most cases, medications that are dopamine agonists, such as cabergoline and bromocriptine (often preferred when pregnancy is possible), are the treatment of choice used to decrease prolactin levels and tumor size upon the presence of microadenomas or macroadenomas. A systematic review and meta-analyses has shown that cabergoline is more effective in treatment of<unk>  than bromocriptine. Other dopamine agonists that have been used less commonly to suppress prolactin include dihydroergocryptine, ergoloid, lisuride, metergoline, pergolide, quinagolide, and terguride. If the prolactinoma does not initially respond to dopamine agonist therapy, such that prolactin levels are still high or the tumor is not shrinking as expected, the dose of the dopamine agonist can be increased in a stepwise fashion to the maximum tolerated dose. Another option is to consider switching between dopamine agonists. It is possible for the prolactinoma to be resistant to bromocriptine but respond well to cabergoline and vice versa. Surgical therapy can be considered if pharmacologic options have been exhausted. There is evidence to support improvement in outcomes of hyperprolactinemic individuals who have shown to be resistant to or intolerant of the treatment of choice, dopamine agonists, through radiotherapy and surgery.
Hyperprolactinaemia
Polycystic ovary syndrome
Hyperproinsulinemia
Hyperinsulinemia
Oxyhyperglycemia
Hyperprolinemia
Hypoglycemia
Hyperinsulinism