Epidemiology and Etiology

Hyperprolactinemia affects women of reproductive age more than men. Although this disorder occurs in less than 1% of the general population, the estimated prevalence in

women with reproductive disorders (e.g., amenorrhea) is as high as 15% to 43%.

Numerous etiologies of hyperprolactinemia are presented in Table 46-4. Any medications that antagonize dopamine or stimulate prolactin release can induce hyperpro-lactinemia.8,31,39,40 Therefore, it is important to exclude medication-induced hyper-prolactinemia from other common causes such as pregnancy, primary hypothyroidism, benign prolactin-secreting pituitary adenoma (prolactinoma), and renal insufficiency. Prolactinomas are the most common pituitary tumors. They are classified as micro-prolactinomas if they are less than 10 mm in diameter and as macroprolactinomas if they are 10 mm or greater in diameter.40 In general, microprolactinomas rarely increase in size, whereas macroprolactinomas have the potential to enlarge and invade the surrounding tissues.41

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