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PROLACTIN AND SECONDARY INFERTILITY
Aliboyeva Dildorakhon Khayrullo kizi¹, Umurzakova Gavkharoy Islamovna²
¹ Second-year student, Andijan Branch of Kokand University, 171000, Uzbekistan, Andijan
² Department of Microbiology, Pharmacology, Normal and Pathological Physiology,
Andijan Branch of Kokand University, 170619, Uzbekistan, Andijan
[
Corresponding author: Email: alibayevadildora2@gmail.com
]
ABSTRACT:
Hyperprolactinemia is a persistent elevation of prolactin levels in the blood
serum. The hyperprolactinemia syndrome is a symptom complex that arises against the
background of hyperprolactinemia, the most characteristic manifestation of which is
impaired reproductive function. The causes of hyperprolactinemia can be diverse, both
endogenous and exogenous. The primary method of treatment is dopamine agonist therapy;
in the case of tumor genesis, surgical and radiation methods are also used. About 15% of
patients exhibit resistance to dopamine agonists, which necessitates the development of
individualized treatment approaches. Timely diagnosis and a properly selected therapeutic
strategy play a crucial role in preventing pathological changes caused by hyperprolactinemia.
KEYWORDS:
Hyperprolactinemia, prolactinoma, pituitary adenoma, dopamine agonists,
therapy resistance, reproductive system, benign breast dysplasia, anovulation.
INTRODUCTION
An elevated level of prolactin in the blood serum indicates the presence of disorders in the
hypothalamic-pituitary system that regulates reproductive function. Hyperprolactinemia is
one of the key causes of dysfunction in the hypothalamic-pituitary-ovarian axis. According
to statistics, prolactinomas are diagnosed in 25–30% of women with pathological
hyperprolactinemia. In addition to tumors, elevated prolactin levels may result from stress,
hypothyroidism, polycystic ovary syndrome, and severe liver and kidney diseases.
The mammary glands are considered a kind of "mirror" of the female endocrine system.
Prolactin stimulates the growth of epithelial cells, increases the number of estrogen receptors,
which increases the risk of hyperplastic processes and fatty transformation of the mammary
gland parenchyma.
MAIN PART
The hyperprolactinemia syndrome develops against the background of chronically elevated
prolactin levels in the blood. Its main symptom is the disruption of menstrual and generative
functions. Prolactin secretion is regulated by neuroendocrine mechanisms involving
neurotransmitters (dopamine, serotonin), peripheral endocrine gland hormones, and other
factors.
Hyperprolactinemia may be:
Physiological
(pregnancy, lactation, stress);
Pathological
(pituitary tumors, hypothyroidism, chronic kidney failure);
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Medication-induced
(antipsychotics, antidepressants, oral contraceptives).
TREATMENT
The choice of treatment method depends on the cause of hyperprolactinemia, the presence of
a tumor process, the level of prolactin, and the patient’s reproductive plans.
Pharmacological treatment
Dopamine agonists —
bromocriptine
,
cabergoline
— are used effectively to lower prolactin
levels and restore ovulatory function.
Surgical intervention
Indicated in cases of prolactinomas resistant to pharmacological therapy or in cases of
severe optic chiasm compression.
Correction of concomitant conditions
Includes treatment of hypothyroidism, discontinuation of prolactin-elevating medications,
normalization of div weight, and hormonal balance correction.
CONCLUSION
Prolactin plays a central role in regulating female reproductive function. Hyperprolactinemia
can be a major factor in the development of secondary infertility, causing anovulation and
menstrual cycle disturbances. Effective therapy requires early diagnosis, identification of the
underlying cause, and individualized treatment selection. Modern methods, primarily
pharmacological therapy with dopamine agonists, offer a high chance of restoring fertility
and normalizing hormonal status.
REFERENCES
1. Korneeva I.E.
Clinic, diagnosis and treatment of infertility in women with functional
hyperprolactinemia
.
2. Dedov I.I., Mel’nichenko G.A., Dzeranova L.K., Pigareva E.K.
Federal Clinical
Guidelines for Hyperprolactinemia
.
3. Maksimova A.V., Pinigina Y.I., Stroev Y.I.
Hypothyroidism, prolactin, and the
female reproductive system
.
4. Varlamova T.M., Sokolova N.N.
Women's reproductive health and thyroid function
insufficiency
.
