Hyperprolactinemia and Ovarian Dysfunction: Clinical and Diagnostic Aspects and Modern Therapeutic Approaches

Abstract

Hyperprolactinemia is a prevalent neuroendocrine disorder that plays a pivotal role in the development of ovarian dysfunction and reproductive impairment in women. Excess prolactin exerts inhibitory effects on the hypothalamic–pituitary–ovarian axis, suppressing pulsatile gonadotropin-releasing hormone secretion and consequently disrupting luteinizing hormone and follicle-stimulating hormone dynamics. This hormonal imbalance leads to impaired follicular development, anovulation, and alterations in steroidogenesis, which clinically manifest as menstrual disturbances, infertility, and, in some cases, galactorrhea. The present study aims to evaluate the clinical and diagnostic characteristics of hyperprolactinemia-related ovarian dysfunction and to analyze current therapeutic strategies. Evidence from recent studies suggests that a comprehensive diagnostic approach, including repeated prolactin measurements, etiological assessment, and pituitary imaging, is essential for accurate diagnosis and differentiation of underlying causes. Therapeutically, dopamine agonists remain the cornerstone of management, effectively reducing prolactin levels, restoring ovulatory cycles, and improving fertility outcomes in the majority of patients. Advances in treatment individualization and long-term management strategies have further enhanced clinical efficacy and safety profiles. In summary, hyperprolactinemia represents a key modifiable factor in ovarian dysfunction, and its timely identification and targeted treatment are critical for optimizing reproductive health and clinical outcomes.