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Case studies

Galactorrhoea and mildly elevated prolactin levels: what is the cause?

JOHN N. CARTER

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Abstract

This case describes a woman with galactorrhoea associated with hyperprolactinaemia. Although there are many physiological, pathological and pharmacological causes of hyperprolactinaemia, many of these can be excluded following a detailed history and physical examination.

Key Points

  • In women with galactorrhoea and a mildly elevated serum prolactin level, a history of normal menstruation indicates that a clinically significant pituitary tumour is unlikely.
  • Pituitary MRI and complete pituitary function tests do not need to be routinely performed in this situation.
  • Hyperprolactinaemia is present in less than 50% of women with galactorrhoea and normal menstruation.
  • Many causes of hyperprolactinaemia can be excluded following a detailed history and physical examination.

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