Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia

Abdallah Adra, Mazen Yousef El Zibdeh, Abdul Malek Mohammed Abdul Malek, Amir Hamrahian, Amr Mohamed Salaheldin Abdelhamid, Annamaria Colao, Elie Anastasiades, Essam Moustafa Aboul Fetooh Ahmed, Jihad Ibrahim Ezzeddine, Mahmoud Ibrahim Abd El Sattar, Suleiman Tawfiq Dabit, Wadih Ghanameh, Navid Nedjatian, Faysal El-Kak

Research output: Contribution to journalReview article

Abstract

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).

Original languageEnglish (US)
Pages (from-to)137-147
Number of pages11
JournalMiddle East Fertility Society Journal
Volume21
Issue number3
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

Fingerprint

Hyperprolactinemia
Uterine Hemorrhage
Prolactinoma
Prolactin
Differential Diagnosis
Pituitary Neoplasms
Serum
Pharmaceutical Preparations
Phlebotomy
Menstruation
Dopamine Agonists
Therapeutics
Physical Examination
Outpatients
Magnetic Resonance Imaging
Hormones

Keywords

  • Abnormal uterine bleeding
  • Dopamine agonists
  • Hyperprolactinemia
  • Menstrual irregularity
  • Prolactinoma

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Adra, A., El Zibdeh, M. Y., Abdul Malek, A. M. M., Hamrahian, A., Abdelhamid, A. M. S., Colao, A., ... El-Kak, F. (2016). Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia. Middle East Fertility Society Journal, 21(3), 137-147. https://doi.org/10.1016/j.mefs.2016.02.001

Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia. / Adra, Abdallah; El Zibdeh, Mazen Yousef; Abdul Malek, Abdul Malek Mohammed; Hamrahian, Amir; 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.

In: Middle East Fertility Society Journal, Vol. 21, No. 3, 01.09.2016, p. 137-147.

Research output: Contribution to journalReview article

Adra, A, El Zibdeh, MY, Abdul Malek, AMM, Hamrahian, A, Abdelhamid, AMS, Colao, A, Anastasiades, E, Ahmed, EMAF, Ezzeddine, JI, El Sattar, MIA, Dabit, ST, Ghanameh, W, Nedjatian, N & El-Kak, F 2016, 'Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia', Middle East Fertility Society Journal, vol. 21, no. 3, pp. 137-147. https://doi.org/10.1016/j.mefs.2016.02.001
Adra, Abdallah ; El Zibdeh, Mazen Yousef ; Abdul Malek, Abdul Malek Mohammed ; Hamrahian, Amir ; 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. / Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia. In: Middle East Fertility Society Journal. 2016 ; Vol. 21, No. 3. pp. 137-147.
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