What Is Hyperprolactinemia

What Is Hyperprolactinemia?

Hyperprolactinemia is a condition where the amount of progesterone in the body exceeds normal. Progesterone is a hormone produced by the ovaries which helps regulate menstrual cycles and other functions. When too much progesterone is present it causes symptoms such as mood swings, depression, fatigue, weight gain or loss, irregular periods and even cancer.

The most common cause of hyperprolactinemia is pregnancy. If a woman becomes pregnant while taking birth control pills she will have elevated levels of progesterone. These high levels of progesterone are not good for her health since they increase the risk of developing certain cancers including ovarian, endometrial, cervical and uterine cancers. However if a woman does not become pregnant during use of birth control pills she will not develop these problems.

Another possible cause of hyperprolactinemia is the use of drugs known as aromatase inhibitors. These medications include the pill, patch, ring and injection. They work by blocking the enzyme that converts testosterone into estrogen. This means that when used by women they do not produce enough estrogen to prevent themselves from having abnormal menstrual cycles or any other side effects associated with high levels of estrogen.

Another side effect of these drugs is an increase in the levels of prolactin in the body leading to hyperprolactinemia.

There are other causes of hyperprolactinemia, however they are quite rare. These conditions include pituitary tumors, genetic disorders, damage to the pituitary gland or even trauma to the head and nervous system.

It is important for a woman to seek treatment for hyperprolactinemia as soon as possible. Prolactin levels can be controlled by taking the drug cabergoline. This medication is taken in tablet form and generally causes few side effects in women. Other types of drugs such as bromocriptine or quinagolide can also be used to treat the condition.

Hyperprolactinemia Treatment

The most common treatment for hyperprolactinmia is cabergoline. This drug is also used to treat various types of cancers and tumors. It works by binding itself to the excessive prolactin receptors in the body. This stops the production of excess prolactin in the pituitary gland, which stops the development of further symptoms and problems caused by this condition.

The drug can be taken orally in pill form. Each dose must be taken daily without exception. The dosage and length of treatment depends on the patient and the severity of their condition. In most cases the drug has few side effects and few people experience nausea, dizziness or headaches when they first start taking it.

In some cases bromocriptine or quinagolide are used to treat hiperprolactinonmia. These drugs also work by binding to the prolactin receptors in the pituitary gland. While these drugs are just as effective at treating the condition they don’t have as many benefits when compared to cabergoline. These drugs have been shown to increase the chances of a person getting heart problems or experiencing low blood pressure.

Possible Side Effects

The most common side effect of cabergoline is nausea, which usually goes away within the first two weeks of treatment. For some people this nausea is severe and can not be tolerated. Other side effects that have been reported include:

Dizziness

Headache

Vomiting

Diarrhea

Stomach ache or pain

Excessive sweating

Weight loss

Blurred vision or changes in eyesight

Difficulty breathing, swallowing or speaking. If you experience any of these symptoms you should seek emergency medical help immediately.

Less common side effects of this drug include:

Depression

Anxiety

Breathing difficulties

Severe fatigue or weakness

Muscle pain, aches or cramps

Severe rash or itchiness over the entire body (although this is rare)

Hallucinations (seeing things that aren’t there, hearing voices)

If you experience any of the above symptoms you should speak to your physician immediately.

Headaches are another common side effect experienced by some people. These types of headaches are often dull and aching in nature. They can be mild or severe and they can happen once or multiple times throughout the day. In most cases these headaches will resolve themselves or lessen in severity as treatment goes on.

If your headaches do not improve in such a way you may need to seek the advice of a medical professional for other treatment options.

Very rarely a person may experience an allergic reaction to cabergoline. Symptoms of an allergic reaction include:

Difficulty breathing

Wheezing

Tightness in the throat or mouth

If you experience any of these symptoms seek emergency medical help immediately.

Serious reactions to this medication are rare, but do happen from time to time. Most can be resolved with treatment, but in some cases the only option may be to stop taking cabergoline.

Long-term use of cabergoline has been linked to heart problems, so anyone who takes this medication on a regular basis should have their heart function monitored at regular intervals.

Some people experience a loss of appetite, which in some cases leads to weight loss. In other cases people experience the opposite and have an increased appetite, leading to weight gain.

In very rare cases people have developed a serious condition called Prolactin-Induced Ovulatory Disorders (PIOD). Symptoms of PIOD include:

Spotting or bleeding between periods

Irregular periods that come more frequently or less frequently

Lack of menstruation for six months or longer

If you experience any of the above symptoms, you should seek treatment from your physician immediately.

Finally, this medication passes into the milk of breastfeeding mothers, so if you are a nursing mother you will need to either stop or speak to your physician about other options.

Older people may need a lower dose of cabergoline, so your physician will adjust your dose depending on your own personal needs.

People with the following conditions should not take cabergoline or should take it only with extreme caution:

Low Blood Pressure

Heart Arrhythmia

Heart Disease

Liver Disease

Kidney Disease

Overactive Thyroid

Parkinson’s Disease

Diabetes or other Endocrine Disorders.

If you suffer from any of the above conditions you should speak to your physician before taking cabergoline.

Cabergoline: How It Works

Cabergoline is a dopamine receptor agonist. In other words, it binds to dopamine receptors and stimulates them, thereby allowing more dopamine in the brain. Dopamine levels are low in people with Parkinson’s disease, but in many cases can be effectively raised with the use of cabergoline.

Cabergoline helps to improve movement and decrease muscle pain in people with Parkinson’s disease. It is most commonly available as a tablet and is taken orally.

Your physician may prescribe this medication on a short-term or long-term basis depending on your specific needs.

This medication may be available as a generic drug.

Cabergoline: Usage

It is very important that you take cabergoline exactly as your physician has instructed. If you experience a ‘missed dose,’ wait until the next day to take your next pill and keep on schedule from there. Do not take a double dose to make up for a missed one.

Cabergoline works slowly but surely to alleviate the symptoms of Parkinson’s disease. Your physician may have you take the medication for one to three months before judging its effectiveness.

This medication may be taken with or without food.

Cabergoline: Possible Side Effects

Most people do not experience any side effects when taking cabergoline. However, some people may experience one or more of the following side effects:

Dizziness

Sore Throat

Headaches

Nausea

Vomiting

If you experience any of these (or any other) symptoms, do not be alarmed. The symptoms should subside within a few days to a few weeks.

If the symptoms persist or worsen, contact your physician immediately.

Cabergoline: Contraindications

Do not take cabergoline if you are pregnant, as it may cause a miscarriage. If you are planning on becoming pregnant in the future, speak to your physician about this medication before taking it.

This drug may cause heart valve problems in certain people. If you have pre-existing heart valve problems, discuss this with your physician before starting treatment.

Cabergoline may cause the following problems:

Low White Blood Cell Count

Severe Depression

Severe High Blood Pressure

If you have diabetes or a history of mental illness, discuss this medication with your physician before starting treatment.

Do NOT take this medication if you are allergic to it or any other part of the cabergoline substance. If you experience an allergic reaction, seek immediate medical attention. Symptoms of an allergic reaction may include:

Itching

Hives

Swelling of the face, tongue, or throat

Difficulty breathing.

Cabergoline may cause the following side effects:

Nausea and Vomiting

Headaches

Severe Back Pain

These side effects usually aren’t serious. If you experience any of these, contact your physician immediately. If your symptoms persist, seek medical attention immediately.

Cabergoline: Storage

Keep this medication in the container it came in, and keep it at room temperature. Protect it from direct sunlight.

Cabergoline: Comments

If you have any questions about this medication, be sure to discuss them with your physician.

Unless you have a condition that this medication can help with, you will not be able to acquire it on your own. You must see a physician and get a prescription for it.

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Cabergoline is sold under the brand names Dostinex and Dompertic.

Updated May 2014

Sources & references used in this article:

Medication-induced hyperprolactinemia by ME Molitch – Mayo Clinic Proceedings, 2005 – Elsevier

Hyperprolactinemia and prolactinomas by T Mancini, FF Casanueva, A Giustina – Endocrinology and metabolism …, 2008 – Elsevier

Diagnosis and management of hyperprolactinemia by O Serri, CL Chik, E Ur, S Ezzat – Cmaj, 2003 – Can Med Assoc

Hyperprolactinemia by J Verhelst, R Abs – Treatments in Endocrinology, 2003 – Springer