– Second half Menstrual cycle(luteal phase)
If a woman's prolactin level is elevated the first time it is tested,
a second sample should be checked when she is fasting and
•A craniopharyngioma is a benign tumor that
develops near the pituitary gland .
• most commonly in childhood and adolescence
•in later adult life.
compresses the pituitary stalk or gland, the tumor
can cause partial or complete pituitary hormone de
Diagrammatic representation of empty sella syndrome.
A, Normal anatomic relationship.
B, C, and D, Progression in development of empty sella syndrome.
Note thinning of floor and symmetric enlargement of sella turcica.
Empty sella sydrome
3. Primary hypothyroidism
• ↑ TRH → stimulates lactotrophs to ↑
Liver cell failure- Chronic renal failure.
Chest wall disease: burn- scar- Herpes
Ectopic secretion:Hypernephroma of
kidney. * Oat cell carcinoma of lung
hyperestrogenic states e.g PCO
A- Inhibition of pulsatile GnRH secretion
1- Hyperprolactinemia inhibit GnRH activity by
interacting with hypothalamic DA and opioid
system via the short-loop feedback mechanism.
Neural control Chemical control
B. Interference with gonadotrophin action in ovary
2-Decreased ovarian sensitivity to pituitary
C-Inhibition of FSH-directed ovarian
• 3-impaired follicular development
D- Inhibition of progesterone synthesis
4-Impaired ovarian strediogensis
• 1- Galactorrhea: Only in 30- 60 % of cases of
hyperprolactinemia due to :
• 2- Infertility: due to:- Anovulation luteal
• 3- Oligohypomenorrhea , even amenorrhea
• 4- Hirsutism due to decreased SHBG.
• 5 -Decreased libido &osteoporosis