Idiopathic hyperprolactinemia: What should we do about it?

Idiopathic hyperprolactinemia is defined as the presence of elevated serum prolactin levels in patients who have no evidence of pituitary or central nervous system diseases and in whom no other recognized causes of increased prolactin secretion are present. It is probably heterogenous in etiology. Some cases are due to macroprolactinemia; others are related to dopamine resistance. Antibody to human prolactin with macroprolactinemia has been identified in some patients. Idiopathic hyperprolactinemia usually runs a benign self-limiting course. Progression to prolactinomas is very rare. Treatment is individualized. Symptomatic idiopathic hyerprolactinemia or that associated with hypogonadism should be treated medically with bromocriptine.