"Dr. Sugar Lecture" is lectured by Tang Xianyu, an expert team from the Endocrinology Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Ershadao Hospital. It will take you closer to the world of endocrinology, popularize knowledge on the prevention and

2024/12/1519:55:32 regimen 1534

opening statement

is a management expert of diabetes and a regulator of endocrine diseases. "Dr. Sugar Lecture" is lectured by Tang Xianyu, an expert team from the Endocrinology Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Ershadao Hospital. It will take you closer to the world of endocrinology, popularize knowledge on the prevention and treatment of endocrine and metabolic diseases with traditional Chinese and Western medicine, and share clinical diagnosis and treatment stories. Promote health and add color to life.

2-year-old Zhao and his wife Li are the same age. After getting married, the couple had normal sexual intercourse and did not use contraception. However, 8 years after marriage, they still haven’t gotten pregnant. What’s going on? The wife couldn't help but begin to wonder if she had a gynecological disease, but she went to the hospital several times for gynecological color ultrasounds and found no problems. So the husband also had a sperm test, and everything was normal. This made the couple even more worried. In order to thoroughly understand the specific reasons and give birth to a healthy baby as soon as possible, the couple went to the endocrinology clinic. After careful examination, the doctor told them: His wife Li had pituitary adenoma and hyperprolactinemia. High prolactin caused her to be unable to ovulate normally, so she was unable to conceive for so long!

1. What is hyperprolactinemia ?

Hyperprolactinemia is a hypothalamic-pituitary dysfunction disease. Due to various reasons, the body's serum prolactin level continues to be higher than the normal value. In terms of clinical manifestations, the main symptoms in women are amenorrhea, galactorrhea, oligomenorrhea, infertility, etc. In men, the main symptoms are loss of sexual desire, erectile dysfunction, reduced sperm count, infertility, osteoporosis, etc.

2. How does hyperprolactinemia occur?

There are many reasons for the increase in prolactin, including physiological factors, drug factors, disease factors, etc.

Physiological factors include exercise, eating, sleep, sexual life, breastfeeding, pregnancy, stress conditions (such as surgery, hypoglycemia, myocardial infarction, syncope, trauma, etc.), etc. The increase in blood prolactin caused by physiological factors is generally not serious, does not fall into the category of disease, and does not require special treatment.

Long-term use of certain drugs, such as dopamine receptor antagonists, antidepressants, estrogen, and birth control pills, can also lead to a mild increase in prolactin.

The most important thing is disease factors, which mainly include pituitary disease, hypothalamic disease, primary hypothyroidism, chronic systemic diseases, polycystic ovary syndrome , etc. The mechanism by which these diseases cause the increase in prolactin is roughly as follows The following types: First, the "autonomous secretion" type, that is, uncontrolled autonomous secretion, leading to an increase in prolactin; the second is the "instruction disorder" type, that is, the pituitary gland that secretes prolactin cannot receive normal instructions or receives wrong instructions, resulting in the secretion of too much prolactin; the third is " The "outward blocked" type means that the prolactin secreted into the blood cannot be cleared or inactivated in time, resulting in an increase in serum prolactin levels.

3. How does hyperprolactinemia lead to infertility ?

The basis for female pregnancy is to have mature follicles and regular ovulation, which requires the support and guarantee of gonadotropins secreted by the pituitary gland. When hyperprolactinemia occurs, will negatively feedback to inhibit pituitary function. Once the pituitary function is inhibited, the synthesis and secretion of gonadotropin will be affected, which will affect the development and maturation of follicles, as well as the synthesis of estrogen in the ovary. , progesterone, eventually leading to follicular dysplasia or non-ovulation, sparse menstruation or amenorrhea, leading to infertility.

4. What situations require investigation of hyperprolactinemia?

. Irregular menstruation : It can be manifested as shortened menstruation, sparse or excessive menstruation, delayed menstruation, amenorrhea, etc.

. Galactorrhea: During non-pregnancy and lactation , liquid will flow out when the nipple is squeezed. In most cases, the amount of secretion is not large, and in severe cases, it may flow out on its own. Especially when the above-mentioned amenorrhea and galactorrhea occur at the same time, hyperprolactinemia needs to be highly suspected.

. Loss of sexual desire: manifested as reduced sexual desire and loss of sex appeal.

4. Symptoms caused by reduced sex hormones: such as breast atrophy, pubic hair loss, vaginal dryness, etc. in women; sparse beards, slow growth, and sparse pubic hair in men.

5. Infertility, infertility.

Hyperprolactinemia is a disease that is not uncommon clinically. Because it affects fertility, it troubles many families. Just like the couple of childbearing age mentioned at the beginning of this article, they were unable to get pregnant after 8 years of marriage. But fortunately, with active diagnosis and treatment, most patients can achieve good results. For example, this young couple gave birth to a healthy baby girl soon after the doctor’s correct diagnosis and treatment, and the wife Li’s compliance with the doctor’s instructions, simple surgical treatment, medication under the doctor’s guidance and regular review and follow-up. , the whole family is very happy