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Hyperprolactinemia has a detrimental effect on fertility both in women and men, leading to galactorrhea anovulation, amenorrhea, oligomenorrhea, impotence, gynecomastia, and low semen profile. Men with hyperprolactinemia not only show abnormal semen analysis but also abnormal histological structure of the testicles with distorted seminiferous tubules and abnormal sertoli cells. Many physiological and or pathological changes involving lactotroph cells can result in hyperprolactinemia. The majority of prolactinomas contains only lactotroph cells and produce prolactin in excess. Antihypertensive drugs like methyldopa and reserpine increases prolactin secretion. A dopamine agonist drug should usually be the first line of treatment for patients with hyperprolactinemia of any cause including lactotroph adenomas of all sizes. Bromocriptine, cabergoline, pergolide are the available dopamine agonists to treat hyperprolactinemia. Dopamine agonists decrease prolactin secretion and reduce the size of the lactotroph adenoma in more than 90 percent of patients. Surgical and radiation treatment are also useful.
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