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In patients presenting with raised PRL, a detailed medical history and examination will exclude many causes of hyperprolactinemia. It is important to rule out pregnancy, take a detailed drug history and enquire about pressure symptoms such as headaches, visual field defects, or cranial nerve deficits to exclude pituitary pathology [10,14]. A single measurement of PRL in a blood sample obtained at any time of the day is usually adequate to document hyperprolactinemia, although the pulsatile nature of PRL secretion and the effect of stress may result in levels that are just outside the normal range [14]. In this situation, obtaining three blood samples at 20 minute intervals is a practical means of confirming or excluding the diagnosis [13]. All hyperprolactinemic samples should be screened for macroprolactin.

Urea, electrolytes, thyroid‐function, liver‐function and pregnancy tests should all be considered. Where there is history of chest pain or lesion, a chest X‐ray may be helpful. Once other causes of hyperprolactinemia have been excluded, MRI is the investigation of choice for pituitary tumors [10].