Symptoms associated with an elevated serum prolactin

Patient

Q: My breasts are leaking. I have not had my period in three months. A pregnancy test is negative. What can be the problem?

Doctor

A:   The symptoms you describe, leaking breasts, absence of periods, with a negative pregnancy test, may be due to an imbalance in your prolactin hormone levels. Prolactin hormone stimulates the female breast to produce milk, and it is secreted from the posterior pituitary gland. High prolactin hormone levels are common in pregnancy, post nipple stimulation and stress but many drugs can cause an elevated prolactin level. Atypical antipsychotic drugs e.g. Respiridone (Risperdal), antidepressant drugs e.g. Clomipramine (Anafranil), and gastrointestinal drugs e.g. Cimetidine (Tagamet) or Metoclopramide (Reglan) all elevate prolactin levels, mainly by blocking of Dopamine D2 receptors. Less common causes of high prolactin levels include pituitary tumours which secrete excess prolactin. In your case it is most likely a drug side-effect, therefore I would advise attending your family physician for prescription of a suitable alternative.

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