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Title: Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia
Authors: Adra, Abdallah
El Zibdeh, Mazen Yousef
Abdul Malek, Abdul Malek Mohammed
Hamrahian, Amir H.
Abdelhamid, Amr Mohamed Salaheldin
Colao, Annamaria
Anastasiades, Elie
Ahmed, Essam Moustafa Aboul Fetooh
Ezzeddine, Jihad Ibrahim
El Sattar, Mahmoud Ibrahim Abd
Dabit, Suleiman Tawfiq
Ghanameh, Wadih
Nedjatian, Navid
El-Kak, Faysal
Affiliations: Faculty of Medicine 
Keywords: Abnormal uterine bleeding
Dopamine agonists
Menstrual irregularity
Issue Date: 2016-01-01
Publisher: Elsevier
Part of: Middle East Fertility Society Journal
Volume: 21
Issue: 3
Start page: 137
End page: 147
Abnormal uterine bleeding may be acute or chronic accounting for up to 30% of outpatient visits to gynecologists. Hyperprolactinemia is one of the most common endocrine disorders associated with ovulatory dysfunction that results in menstrual irregularities. Prior to initiating treatment, the various causes (physiologic, pathologic, pharmacologic, or idiopathic) of hyperprolactinemia must be elucidated. Prolactin is a stress hormone that increases in response to stressful conditions; therefore, while collecting samples it is necessary to reduce venipuncture stress. A thorough patient history and physical examination will help to identify the cause and to direct therapy. Imaging results must always be assessed along with a patient's clinical history and biochemical parameters when a pituitary tumor is suspected. Magnetic resonance imaging is the method of choice for the diagnosis of microprolactinomas and macroprolactinomas in both initial assessment and follow-up. Several drugs may cause a significant increase in serum prolactin concentration. If clinically feasible, the drug should be discontinued; if this is not possible, it should be substituted with a drug of similar action that does not cause hyperprolactinemia. Prolactinomas are the most common cause of pituitary adenomas affecting women of fertile age leading to significant elevations in prolactin that warrant treatment. Idiopathic hyperprolactinemia may be observed in the presence of elevated serum prolactin levels and in the absence of any other recognized cause of increased prolactin secretion. Dopamine agonists are the mainstay of therapy in prolactinomas and symptomatic idiopathic hyperprolactinemia because they normalize serum prolactin, effectively shrink prolactinomas and normalize gonadal function (i.e. menstruation).
ISSN: 11105690
DOI: 10.1016/j.mefs.2016.02.001
Ezproxy URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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