Hyperprolactinemia Workup

Updated: Feb 09, 2022
  • Author: Donald Shenenberger, MD, FAAD, FAAFP; Chief Editor: George T Griffing, MD  more...
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Laboratory Studies

Generally, hyperprolactinemia is discovered in the course of evaluating a patient's presenting complaint, for instance amenorrhea, galactorrhea, or erectile dysfunction. Occasionally, several fasting measurements of prolactin must be obtained.

Current thyroid-stimulating hormone assays are very sensitive for detecting hypothyroid conditions.

Measuring blood urea nitrogen and creatinine is important for detecting renal failure.

History of alcohol abuse and abdominal examination may give clues for cirrhosis as a possible etiology.

Pregnancy testing is required unless the patient is postmenopausal or has had a hysterectomy.

Patients with macroadenoma should be evaluated for possible hypopituitarism. Male patients should have testosterone levels checked.

Many patients with acromegaly have prolactin co-secreted with growth hormone. Anyone thought to have acromegaly should be evaluated with an insulin-like growth factor-1 (IGF-1) level measurement and a glucose tolerance test for nonsuppressible growth hormone levels if needed.


Imaging Studies

Although modern high-speed helical CT scanners produce very detailed images, MRI is the imaging study of choice. MRI can detect adenomas that are as small as 3-5 mm.


Other Tests

These would be determined by any identified cause, (eg, visual-field testing especially if a pituitary macroadenoma is found or if optic nerve involvement is noted on imaging studies).