Stress-Induced Hyperprolactinemia: Pathophysiology and Clinical Approach

Table 1

Common etiologies of hyperprolactinemia [2, 5, 6, 14, 15, 19, 20].

Physiologic causes	Pregnancy, nipple stimulation, stress, lactation, sexual intercourse/Sexual orgasm, venipuncture, chest wall stimulation (trauma, herpes zoster), high protein diet, exercise, hypoglycemia
Pituitary disease	Prolactinomas (microadenomas and macroadenomas); acromegaly, empty sella syndrome; lymphocyctic hypophysitis
Hypothalamic disease	Craniopharyngiomas, meningiomas, dysgerminomas, Rathke’s pocket cyst, other tumors, sarcoidosis, eosinophilic granuloma, neuraxis irradiation, arteriovenous malformations, pituitary stalk section
Neurogenic	Chest wall lesions, spinal cord lesions
Systemic disease	Hypothyroidism, chronic renal failure, hepatic cirrhosis, Cushing’s disease; Addison’s disease, histiocytosis X, temporal arteries inflammation; chronic uremia; SLE; multiple sclerosis; Sjogren’s syndrome
Other	Pseudocyesis, polycystic ovary syndrome; epilepsy; meningitis, mutation in prolactin receptor gene (His188Arg)