Pathology:                    Elevatedprolactin levels


Aetiology:                     Physiological: Stress, pregnancy,breast feeding

                                          Drugs: Methyldopa, metoclopramide,haloperidol, oestrogen

                                          Malignancy:Microprolactinoma(<10mm diameter) or Macroprolactinoma

(>10mm diameter)


Symptoms:                   Reduced/absentmenstruation, galactorrhoea, breast tenderness, headaches, lack of libido, sub-fertility,erectile dysfunction


Signs                               Visual defects


Investigations:          Bloods: Serum prolactin, pituitaryfunction, TFTs,

                                        Specialtests: Visual field assessment

                                       Imaging:  MRI pituitary


Treatment:                  Medical: Stop offending drugs, Dopamine agonist therapy withbromocriptine or

cabergoline to normalise prolactin ifmalignancy

                                          Surgical:Trans-sphenoidal surgery


Complications:          Osteoporosis


Prognosis:                   Usuallygood prognosis


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