What is elevated prolactin? Elevated prolactin in women

Prolactin is a hormone produced in the pituitary gland. An increase in prolactin levels in the blood in women is called hyperprolactinemia. Women planning pregnancy often experience elevated prolactin levels.

Prolactin in women is a hormone that has a direct effect on menstrual and reproductive function. There are three fractions of prolactin in a woman’s body:

Monomeric prolactin has the greatest activity. It makes up more than 80% of all factions.

Numerous scientific studies have established the role of the hormone in a woman’s body. Its main functions are as follows:

maintaining the development of the corpus luteum of the ovary in the luteal phase of the menstrual cycle;
breast growth during puberty;
preparing the glands for lactation during pregnancy;
milk production in the breast to feed the baby;
throughout pregnancy, the hormone allows you to maintain a constant level of progesterone, necessary for bearing the fetus;
obtaining orgasm during sexual intercourse;
formation of maternal instinct.

During lactation, prolactin, on the contrary, inhibits the production of progesterone and inhibits ovulation. This ensures natural contraception in the postpartum period.

Studies have confirmed that the higher a woman's prolactin level during pregnancy, the lower her pain threshold during childbirth.

However, outside of pregnancy, elevated prolactin levels are considered a pathology requiring treatment.

Reasons for increased prolactin

Prolactin is also called the “stress hormone”. This is all because its level fluctuates significantly depending on external and internal factors. There are physiological and pathological causes of hyperprolactinemia.

Physiological reasons are associated with natural processes occurring in the body. The influence of natural factors is reversible. These reasons are considered:

Pathological causes of increased prolactin in the blood are associated with concomitant diseases. Pathological causes include:

insufficient functioning of the thyroid gland (hypothyroidism);
radioactive exposure;
pituitary tumor;
hypothalamic disease;
liver failure;
cirrhosis of the liver;
tuberculosis;
chronic kidney disease;
diabetes;
drug use;
taking certain medications (tranquilizers, antipsychotics, hormonal contraceptives with a high content of estrogen component).

Prolactin levels are elevated for some time after gynecological operations such as abortion and uterine curettage.

Symptoms of increased prolactin

The first symptom of increased prolactin, with which a woman most often consults a doctor, is menstrual irregularity. As a result of hormonal changes, there is a lack of pregnancy or spontaneous abortions at short term.

Symptoms that require examination of prolactin levels in the blood are:

An increase in prolactin often causes depression. This is due to a violation of the body's hormonal homeostasis.

Diagnostics

First of all, to confirm hyperprolactinemia syndrome, venous blood is examined for prolactin content. Preparation for a blood test plays an important role in diagnosis.

Women who use medications for a long time should stop taking them a week before the test. 3 days before donating venous blood to determine the level of the hormone, it is necessary to avoid sexual contact and physical irritation of the nipples. These factors can cause a physiological spike in prolactin.

The day before donating blood, you must stop smoking, alcohol, fatty foods, and beans. However, you should not refuse dinner. Vegetable salads do not have a pathological effect. Fasting also causes prolactin levels to rise.

It must be remembered that nipple stimulation and sexual intercourse increase hormone levels. Therefore, one day before determining the hormone level, you need to refrain from sexual intercourse and sexual arousal.

Blood must be donated 2-3 hours after waking up at rest. Blood is drawn in the morning on an empty stomach. Women of reproductive age should be examined on days 3–5 and 22–25 of the menstrual cycle. A single increase in prolactin levels is not considered a pathology. The examination is carried out over three menstrual cycles. A deviation from the norm is considered to be high hormonal levels in three dimensions.

The normal level of the hormone is considered to be up to 500 mIU/l. An increase in hormone levels to 1000 mIU/l is a reason for dynamic monitoring and finding out the causes of hormonal imbalance. When the hormone increases to values of 1500 mIU/l, drug treatment is required. A prolactin level of 2000 mIU/l may indicate the presence of a pituitary tumor and requires careful observation, treatment and dynamic monitoring.

To find out the cause of the increase in prolactin, a number of examinations are required. The main ones are:

CT or MRI of the brain;
Ultrasound of the thyroid gland, abdominal organs and kidneys;
determination of blood sugar levels;
examination of the hormonal function of the thyroid gland;
blood chemistry;
consultation with a neurologist;
consultation with an endocrinologist;
consultation with an ophthalmologist with fundus examination.

Using ultrasound of the mammary glands, the presence of secondary changes - cystic and tumor-like formations - is determined. After the examination, the probable factor that caused the increase in prolactin is determined. Recovery directly depends on eliminating the cause.

Consequences of increased prolactin

The main and serious consequence of increased prolactin in the body of a woman of reproductive age is the inability to conceive a child. The condition is associated with suppression of the secretion of hormones that regulate the ovulation process. In 90% of patients, menstruation occurs extremely rarely.

As a result of hormonal dysfunction, the egg in the ovary does not mature. And if fertilization does occur, then against the background of altered hormonal levels, the placenta does not form. Spontaneous abortion occurs at 8–10 weeks of pregnancy.

Long-term high levels of the hormone lead to changes in the structure of the glandular tissue of the mammary glands, which is called mastopathy. Breast disease is accompanied by painful sensations that intensify before menstruation. The lack of comprehensive treatment for mastopathy can cause the development of cancer of the glandular tissue.

Sometimes serous contents accumulate in the dilated ducts of the mammary glands, which become inflamed when immunity decreases. Inflammation of the breast lobe is called mastitis. The disease is characterized by acute pain, increased body temperature and enlarged axillary lymph nodes.

Prolactin is involved in the process of sexual arousal and orgasm. Increased levels of the hormone lead to frigidity and decreased libido. Hyperprolactinemia leads to increased appetite. Excessive appetite leads to excess body weight.

Prolactin plays an important role in calcium metabolism. A high level of the hormone in the blood for a long period leads to the removal of calcium from the bone. Hyperprolactinemia causes the development of osteoporosis.

High levels of the hormone make you think about the presence of a tumor in the brain, which is called prolactinoma. The growth of the tumor causes headaches, memory loss and impaired visual acuity. Serious hormonal imbalance is the cause of severe depression.

Therapy methods

Treatment of elevated prolactin in women is carried out with hormonal drugs aimed at suppressing prolactin synthesis. The main groups of medicines include:

Women planning a pregnancy are prescribed a drug called bromocriptine. The course of treatment is at least six months. Sometimes conservative therapy lasts up to three years.

If hyperprolactinemia is caused by a tumor that is not amenable to drug treatment, then the issue of surgical treatment is decided. When there are contraindications to surgery, radiation therapy is used. However, the method is used only with rapid growth of prolactinoma to stabilize the condition.

At the same time, treatment is carried out for concomitant diseases that could be the root cause of the increase in hormone levels. Drug therapy restores the menstrual and reproductive function of the female body.

Women who have been diagnosed with hyperprolactinemia should be monitored by a gynecologist, endocrinologist and mammologist. Before starting treatment, the root cause of the disorder must be established. Taking medications without a doctor's prescription can be harmful to your health.

Hormones are a capricious thing, but necessary for the female body. How often have we associated our upset feelings with the unpredictable behavior of some hormone or explained physiological changes also by the production of one or another “helper” of the body. Hormones, in fact, are the masters of any situation, since they can easily control not only our behavior and feelings, but also important physiological processes in the body. That is why any pathologies in the functioning of hormones, including increased prolactin in women, should be diagnosed in time and the necessary measures taken.

As we have already drawn your attention, hormones are very important biological components of the body that reach us thanks to the work of certain glands. Hormones, like law enforcement officers, monitor the functioning of most functions of our body. Almost every important life function you can imagine is driven by hormones. They influence the growth of the organism, its overall development and the development of all its individual parts, and human reproduction.

Prolactin is one of the most important hormones in our body, which is produced by the brain, namely the pituitary gland. This hormone is responsible for the growth of mammary glands in the fair sex and for the production of necessary breast milk during lactation.

A normal amount of hormones in the body makes it possible to breastfeed a baby, but an increased hormone prolactin in women during pregnancy and in non-pregnant women can have quite serious consequences.

Symptoms of elevated prolactin

When a woman has irregular menstruation, the desired pregnancy does not occur, but there is discharge from the mammary gland, and a man has decreased sexual potency, we may have symptoms of increased prolactin and the doctor must first determine the level of the hormone prolactin. Why?

Normally, prolactin activates lactation, stimulates the manifestation of the maternal instinct, regulates reproductive processes, and, to a lesser extent, the growth and development of the mammary glands, as well as the sebaceous glands, and individual internal organs. In men, this hormone primarily affects the growth of the prostate and seminal vesicles.

Insufficient secretion of prolactin sometimes affects the underdevelopment, for example, of the mammary glands (although this is not the only reason), and a violation of their function. But more often problems arise when the hormone enters the blood in excess.

It must be said that until the early 70s, the presence of the hormone prolactin in humans was questioned. At the turn of the 60s - 70s, three significant discoveries in medicine coincided chronologically, radically changing the fate of many women who suffered from infertility and impotence of men.

It has been proven that not only in animals, but also in humans, the pituitary gland produces the hormone prolactin, which has broad biological activity, and a method for determining it in the blood has been proposed. Almost simultaneously, the method of layered tomography of the head that appeared made it possible to verify that even the smallest benign tumors of the pituitary gland contribute to the uncontrolled “overproduction” of the hormone - hyperprolactinemia. At the same time, a treatment was obtained for elevated prolactin, which is one of the common causes of infertility and sexual problems.

So what does increased prolactin signal to an endocrinologist? Only an endocrinologist is able to understand the complex picture of the interaction of hormones in the body and identify the cause of increased prolactin. Excess prolactin, due to general regulatory mechanisms, can be caused by damage to the thyroid gland or polycystic ovary syndrome, and then very complex correction is necessary. In people with liver and kidney diseases, prolactin is sometimes elevated because the process of its absorption and excretion is disrupted.

A number of drugs prescribed to treat peptic ulcers (for example, cerucal, eglonil), to lower blood pressure (reserpine and its derivatives), many antidepressants and tranquilizers naturally change the level of prolactin in the blood. When a woman’s menstruation disappears while taking medications, doctors decide what is more important at this stage: to come to terms with the irregular cycle and treat the underlying disease or replace medications.

Contraceptive estrogen drugs require individual selection. Undoubtedly indicated for healthy women, with existing disruptions in the menstrual cycle, estrogens can further “spin” the process of increasing prolactin. Therefore, such women need to check their hormonal levels before choosing a contraceptive.

A powerful stimulator of “overproduction” of the hormone is drugs. Menstruation disorders, infertility in women, and impotence in men - is it worth taking the potion for such prospects? And doctors cannot avoid asking their patients who have excess prolactin: are you not taking drugs?

Elevated prolactin is detected more often at the age of 20 - 30 years. But in some adolescents it is detected already during puberty. A girl’s first menstruation is sometimes delayed precisely because she has a prolactin-secreting pituitary adenoma, which can cause delayed puberty in a boy. Cases are quite rare, but they do happen.

Causes of elevated prolactin in women

Let's talk about women. The cause of elevated prolactin in women is not necessarily associated with pathology. This is explained either by physiological reasons (pregnancy, lactation), or reflex ones - the presence of an intrauterine contraceptive device such as a device, endometriosis, or an inflammatory disease in the reproductive sphere. The fact is that although the main source of prolactin is the pituitary gland, small amounts of the hormone are produced by the placenta, endometrium, and ovaries.

This hormone is very “responsive” to emotions; it is called the behavior hormone. Stimulation of the nipples, including sexual caresses of the breasts, also increases its level.

According to modern international standards, the upper limit of normal prolactin in women is considered to be 500 - 600 microunits per 1 liter of blood.

If the hormone level is somewhere between 10 and 40 units higher, there is no cause for concern, but when it is almost an order of magnitude higher, sometimes reaching 40 thousand units, it is most likely prolactin from the pituitary gland, and prolactinoma is to blame - a benign tumor from its cells, producing this hormone.

The normal level of the hormone in the body of a woman who is not pregnant or breastfeeding is from 15 to 20 nanograms per 1 ml of her blood. The indicators will be higher for expectant mothers and those women who are already breastfeeding their baby. In this case, the level can reach up to 300 nanograms. The reasons why elevated levels of the hormone prolactin occur in women can be of various types.

The physiological cause of this phenomenon will be various active activities of the woman or disruptions in normal comfortable performance. Such physiological factors include sex, sleep, stress, pregnancy or breastfeeding, intake of protein and protein foods, irritation of the nipple.

Taking various medications can also significantly affect the amount of hormone production in the female body. We will include this factor under pharmacological causes. Prolactin levels can be affected by oral contraceptives that contain high levels of estrogen. The influence of antiemetics, antidepressants, blood pressure-lowering drugs, the use of narcotic substances and psychotropic drugs is also undeniable. Don't forget to tell your doctor about all the medications you are currently taking. Perhaps it was they who provoked such pathologies in the production of the hormone.

The dangerous and pathological causes that we have already mentioned will be the more serious diseases listed below. Increased prolactin in women can be provoked by a tumor of the pituitary gland, disruption of the normal functioning of the thyroid gland, inflammation and other diseases of the ovaries, and disturbances of the entire hormonal background of a woman. Kidney disease can also provoke an increase in adequate levels.

Whatever the reason, the problem of increased hormone levels must be dealt with immediately. Modern traditional and folk medicine provide several options for combating disorders

Causes of elevated prolactin in men

In men, the causes of elevated prolactin usually indicate pathology. Although there are exceptions. Some people produce a special form of prolactin - the so-called “big” prolactin. In such cases, the protein molecules of the hormone appear in the form of conglomerates. It is not biologically active, so excess does not matter. More often than not, this is an accidental finding and can cause a lot of unpleasant excitement if hormones are determined “just in case.”

Of course, there is no reason for joy if you have a high level of prolactin, and a tomogram shows the presence of a small adenoma in the anterior lobe of the pituitary gland. But you shouldn’t indulge in universal sadness either.

Prolactin is elevated - consequences

As with any pathology, violation of the norm of prolactin levels leads to certain problems.

Typically, elevated levels occur in every second woman who suffers from infertility or menstrual irregularities. A high level of the hormone may indicate the presence of a tumor in the part of the brain where the hormone is produced - in the pituitary gland.

Impaired prolactin levels in nulliparous women can cause milk to be released through the breasts. Milk begins to be released in small droplets, both independently and after slight pressure. The discharge may even come in trickles. As a rule, this entails the development of mastopathy in women and requires immediate treatment. In addition, the removal of essential calcium from breast milk causes osteoporosis. That is why anyone who is faced with the problem of milk secretion or nursing mothers should consume a sufficient amount of dairy products or cheese every day.

Elevated prolactin in non-pregnant women leads to disruptions and disturbances in the monthly cycle. After a short time, menstruation may disappear completely. Excessive levels of this hormone affect both the normal functioning of the thyroid gland and hormonal levels in general. Patients with this pathology begin to suffer from increased appetite. Over time, this affects the woman’s excess weight.

The hormone also affects the patient’s well-being. As normal levels increase, women complain of memory loss and confusion. A sharp deterioration in concentration and loss of vision may indicate a benign tumor that presses on the optic nerve. In all respects, an increase in prolactin has a detrimental effect on the state of the patient’s nervous system. Representatives of the fairer sex become nervous, irritable, and whiny. Depression worsens and hysterics arise even out of the blue. A depressed state develops against the background of chronic insomnia. Patients cease to adequately accept the reality around them.

The occurrence of such a pathology as increased prolactin hormone in women is influenced by a number of different reasons.

Treatment

Modern medicine “provides” a good prognosis for this diagnosis.

What do they do with the tumor? It all depends on its size and the specific life situation of the patient.

For the treatment of elevated prolactin, men are most often offered surgery, since their adenoma is discovered at a later date, and it grows more actively. If the tumor is large, it can put pressure on the optic nerves and become a threat to vision.

This can also happen in women, although their benign and small adenoma grows very slowly or does not grow at all. And the drug ergot sorceress - bromocriptine, better known in our country as parlodel, has the ability not only to reduce and normalize prolactin levels, but also to destroy, or at least reduce the size of the tumor. Therefore, treatment, as a rule, begins with the appointment of Parlodel, even for men. The drug helps to significantly shrink the tumor before surgery, making it easier for surgeons to remove it.

Currently, not only Parlodel from Sandoz is used, but also an excellent domestic ergot preparation - Abergin. Parlodel analogues are available to our patients - bromergon, pravidel.

A woman, if she tolerates the drug well and there is no threat to her vision due to a pituitary adenoma, can take the medicine for a long time, up to 3 years, intermittently. Many people successfully give birth while taking Parlodel and only thanks to it. So what next? Menstrual irregularities may recur. Should I continue to take the medicine?

If a woman wants to give birth again, if she is concerned about decreased libido, lack of orgasm, vaginal dryness, excess weight sometimes caused by increased prolactin, treatment continues. But some patients, who do not like careful and long-term treatment, believe that the irregularity of menstruation does not bother them. In such cases, after consulting with your doctor, you can refuse Parlodel. But keep in mind that over time, a significant excess of prolactin and associated cycle disorders can cause increased bone fragility.

Prevention of elevated prolactin

There are no specific measures to prevent elevated hormone levels. The most general recommendations: do not abuse medications, it is better not to sunbathe - after all, insolation stimulates the hypothalamus, and it, in turn, the pituitary gland... Probably, excessive tanning contributes to the development of a pituitary tumor. And maybe, instead of a sleeping pill or a sedative, it is sometimes better to take valerian?

I would like to advise women who have discovered lactorrhea (discharge from the mammary gland) not to squeeze the contents out of the nipple. This only stimulates the production of prolactin. More often, this is simply the individual sensitivity of the breast tissue to normal levels of the hormone, but by constantly pressing on the nipple, you push the process of increasing prolactin.

By the way, small discharge from the mammary gland for 2 - 3 years after childbirth or abortion is within normal limits. And only if, in the absence of pregnancy and menstruation, there is this discharge, prolactin must be checked. In any case, consult a doctor, because discharge can serve as a signal of some other problem.

How to reduce hormone levels

As we have already learned, as soon as you notice something wrong, immediately go for a consultation with your doctor. On the first day of your period, as soon as possible after you wake up, get your blood tested. The analysis is taken no later than three hours after you wake up. Do not forget to prepare your body for the analysis, try not to drink alcohol the night before, do not stimulate the mammary glands and in every possible way exclude intimacy with your partner. If you are a smoker, then it is better to refrain from smoking an hour before donating blood.

Such an analysis does not immediately show the result. To determine the diagnosis, you will need to donate blood three times. As a rule, elevated prolactin in women is diagnosed only if two out of three tests indicate this, and only after the patients undergo several more necessary tests. For a clear diagnosis, a blood test for calcium, ultrasound of the mammary glands and MRI of the brain will be required. All these tests will help not only to determine the occurrence of pathology, but also to understand the causes of its occurrence.

After the diagnosis has been completed, patients are prescribed the necessary medications with strict individual dosages. Since the reasons for the increase in level may be different, the treatment will be completely different in each individual case. That is why self-medication is excluded. For prevention, you can only stop using certain medications and sunbathe less.

When elevated hormone prolactin in women affects their psychological state, traditional medicine can make them feel a little better. Motherwort and valerian will help normalize the condition of patients and calm them down. Hops, St. John's wort, hawthorn, lemon balm and mint will help stabilize emotional balance, and a healthy lifestyle will contribute to a speedy recovery.

We remind you that folk remedies can only alleviate your condition a little, but you cannot do without professional treatment.

G. A. MELNICHENKO, Professor, Department of Endocrinology, Moscow Medical Academy named after I. M. Sechenov

What is prolactin? This is a hormone produced by the pituitary gland and is responsible for the proper development of the mammary glands and the reproductive function of a woman. It helps the immune system fight harmful pathogens, turns on the maternal instinct, and reduces stress levels.

In addition, prolactin is an essential element in the process of implantation of a fertilized egg, increasing the number of receptors sensitive to progesterone.

In the body of men, prolactin is contained in minimal quantities and promotes the synthesis of male sex hormones, spermatogenesis, and also plays the role of an important immunostimulant.

Physical labor, sports activities, eating meat dishes, and an active sex life affect the concentration of the hormone in the blood, causing fluctuations in its level.

The causes of such a phenomenon as increased prolactin, or hyperprolactinemia, can be constant stress, taking medications, benign and malignant neoplasms, and even chronic diseases (polycystic disease, adrenal insufficiency, etc.).

Advice! Conduct a preventive medical examination once a year.

Elevated prolactin: symptoms and consequences

The first is diagnosed in pregnant and recently given birth representatives of the fair half of humanity. This is not scary, because the reasons why prolactin is elevated in women are clear (the need to bear a fetus and breastfeed a baby).

The second type provokes a malfunction of the body. One of the reasons for high prolactin in women (and men) can be a tumor of the pituitary gland. There is no need to be alarmed ahead of time: only a doctor, after a thorough examination, will be able to clarify the cause of the illness.

So, hyperprolactinemia - what is it? This is a condition of the body in which increased prolactin is recorded in the blood. In women, symptoms indicating an increase in hormone concentrations are as follows:

galactorrhea (discharge of milk from the breast not related to pregnancy and lactation);
decreased libido, lack of orgasm, even frigidity;
hirsutism (hair growth in women all over the body, near the nipple, on the face, abdomen);
acne (blackhead rash);
increased appetite and, consequently, the appearance of overweight and even obesity;
malfunction of the thyroid gland;
blurred vision;
frequent depression, excessive fatigue;
inability to conceive, inability to fertilize (due to anovulatory cycles), repeated miscarriages in early pregnancy;
leaching of calcium from bone tissue.

Prolactin control is the basis of women's health

The symptoms of hyperprolactinemia in women are clear. It is worth noting that not only representatives of the fair half of humanity suffer from such changes in the body. In men, increased prolactin can manifest itself as follows: potency weakens, interest in the opposite sex disappears.

Advice! If you notice any of the above manifestations of hyperprolactinemia, consult a doctor, because high prolactin can also occur with tumors.

Consequences of high prolactin in men:

changes in the shape and size of the mammary glands (gynecomastia);
overweight;
long-term depression;
impotence and infertility;
lack of sleep;
sexual infantilism.

Men are more sensitive to the manifestations of hyperprolactinemia, their mood drops sharply, irritability appears, and motivation decreases. As a result, poor psychological well-being negatively affects the quality of life.

Diagnostics

To understand the reasons for the development of hyperprolactinemia, you need to undergo a medical examination.

There are several types of laboratory and instrumental studies that can help find the cause of a hormonal surge:

MRI of the brain, in particular the pituitary gland (this manipulation allows us to identify the presence of malignant and benign neoplasms);
X-ray of the skeleton (to assess changes in the condition of bone tissue);
checking thyroid function (ultrasound plus additional tests);
Ultrasound of vital organs (to identify their pathology);
glucose tolerance test (especially if you are overweight - blood sugar concentration);
visit to an ophthalmologist.

Important! The normal prolactin level ranges from 120 to 600 mU/l.

To get results, you need to donate blood from a vein in the morning, on an empty stomach (you can only drink water). You should not smoke 1 hour before the test. Before donating blood, the patient needs to be in a relaxed state: try to avoid depression, sexual intercourse and thermal influences (sauna, solarium) at least 24 hours before.

Proper preparation is the key to correct analysis results

Prolactin levels are normal

In women, the level of this hormone in the blood can range from 4.5-49 ng/ml to 136-1483 µIU/ml, as it depends on what day of the cycle the test is taken. There are phases:

Follicular: 4.5-33 ng/ml or 136-999 µIU/ml.
Ovulatory: 6.3-49 ng/ml or 190-1484 µIU/ml.
Luteal: 4.9-40ng/ml or 148-1212 µU/ml.

During pregnancy, a woman’s prolactin is increased (the hormone changes its level depending on the period):

1st trimester: 3.2-43.0 ng/ml;
2nd trimester: 13.0-166.0 ng/ml;
3rd trimester: 13.0-318.0 ng/ml.

In men, hormone levels are normally lower than in women: the concentration ranges from 2.5-17 ng/ml, or 75-515 µIU/ml.

Treatment of hyperprolactinemia

How to lower prolactin in women? Modern science offers several treatment options:

Medication.
Surgical.
Using folk remedies (using soothing infusions a couple of hours before bedtime or using dietary supplements).

Drug treatment

Drugs are used that reduce the production of prolactin. There are two groups of medicines:

Ergoline (ergot alkaloids): Bromocriptine, Lactodel, Parlodel, Serocriptine, Bromergon, Abegreen, Dostinex. Therapy is generally well tolerated by patients, side effects are mild (some people complain of low blood pressure and headaches after taking the pills).

Dostinex is the most effective drug among the entire range of medications. The active ingredient is cabergoline. Available in the form of tablets of 0.5 mg, 8 pieces in a package. Dostinex blocks the production of prolactin, allowing the follicle to mature in time and restore the menstrual cycle. As a result, ovulation occurs and pregnancy becomes possible.

Dostinex is a drug that reduces prolactin production and restores the menstrual cycle.

Non-ergoline (quinagolide preparations): Sebergin (for mastopathy), Norprolac, etc.

Important! All these drugs are prescribed individually by the attending physician. And you, in turn, are obliged to adhere to all recommendations.

Surgical intervention

Surgery is prescribed if hyperprolactinemia is caused by tumor growth, and drug treatment has not given good results. Removal of tumors is carried out by neurosurgeons, the route is transnasal, without craniotomy. Oncology requires radiation therapy, but complications are possible in 90-100% of cases.

Nutrition for high prolactin

In addition to the treatment methods discussed, the patient is prescribed a strict diet. Then the next question arises: “What can you eat if you have high prolactin?”

If you have obvious symptoms of elevated prolactin, you should eat foods rich in folic acid. This approach helps to better absorb proteins, improves hematopoiesis, and increases estrogen levels. Folic acid is found in required quantities in meat products, liver, greens, eggs, and vegetables.

Important! A huge percentage of folic acid is lost during cooking (during cooking). Therefore, regular consumption of fresh fruits and vegetables is necessary.

Intestinal diseases reduce the absorption of an important substance, and medications even change its structure. It has been established that folic acid cannot be absorbed into the blood without vitamin B12. Therefore, the diet of women with high prolactin should include not only vegetables and herbs, but also lean meats.

In this case, it is necessary to exclude gluten-containing products: bread made from white flour, biscuits, cakes, as well as smoked sausages and sausages.

In order not to treat elevated prolactin in women or men, it is necessary to carry out prevention, namely:

Properly distribute the load, observe the work schedule (get enough rest), because a clear schedule and sleep will improve the general condition of the body.
Eliminate strong coffee and alcohol from your diet.
Eliminate possible causes of increased prolactin (cure existing diseases).
Have a medical examination every year.

Important! When a doctor concludes “prolactin is elevated,” you should not despair, because hyperprolactinemia is not a death sentence, but a condition that can be eliminated with a competent, timely approach.

Treatment with modern and effective drugs allows in 90% of cases to achieve positive results: normalization of the menstrual cycle and even elimination of infertility. Take full responsibility for your health, and your body will thank you!

Prolactin (mammotropin) is a hormone that is synthesized by the pituitary gland under the influence of the hypothalamus. It affects the reproductive function of the body. Its increased concentration helps reduce testosterone and estrogen levels.

The main function of the hormone is to ensure lactation in women after the birth of a child. Prolactin receptors are present not only in the uterus and ovaries, but also in the heart, kidneys, liver, lungs, spleen and skeletal muscles. A small amount of the hormone is produced in the mammary glands, placenta and lymphocytes.

A woman's body produces several forms of prolactin:

Monomeric. This is the most active form, causing changes in the female body. If monomeric prolactin is elevated in a woman, various disorders may develop. This is why it is believed that this type of hormone is the most dangerous.
Dimeric. This form of prolactin does not bind to cellular receptors, therefore, even with its excess in the body, symptoms of hyperprolactinemia are not observed.
Polymer. The large molecules of this substance do not pass through the walls of the capillaries and, as a result, the hormone has no effect on the body. Even a high level of this type of mammotropin does not cause symptoms of hyperprolactinemia, so there is no need to lower it.

Causes of elevated prolactin

Normally, non-pregnant women produce prolactin from 4.1 to 34 ng/ml.

If prolactin is elevated in a woman, the cause is most often pregnancy. Hormone levels increase with each trimester. This makes it possible to replace fatty breast tissue with glandular tissue, suppress progesterone levels and reduce the sensitivity of the mammary glands, preparing them for breastfeeding.

Various reasons can lead to increased prolactin levels in women.

Prolactinoma

This is a fairly common tumor of the pituitary gland, which causes increased prolactin in women. Depending on the size, macroprolactinoma (more than 1 cm) and microprolactinoma (less than 1 cm) are distinguished. In most cases, the tumor does not cause unpleasant symptoms, so it is usually discovered by chance.

If prolactin is elevated in women as a result of large pituitary tumors that are not amenable to drug therapy, they may be destroyed using ionizing radiation.

If the tumor reaches a large size and leads to visual impairment, treatment is necessary, most often with hormonal drugs. In very rare cases, surgery is performed.

Also, the cause of changes in the level of mammotropin may be various neoplasms that block the pathways between the hypothalamus and the pituitary gland. They occur much less frequently than prolactinomas and cause an increase in the levels of other hormones.

Surgical interventions and injuries

If surgery was performed in the abdominal area, the level of mammotropin in the blood may increase for several days. During operations on the chest or when it is damaged due to injury, high levels of the hormone can remain in the body for several months.

Taking medications

The level of mammotropin is influenced by antipsychotics, antituberculosis drugs, antiemetics, opiates and oral contraceptives. After completion/cancellation of therapy it returns to normal.

Other reasons

Prolactin also increases in women against the background of the following pathologies:

shingles;
pituitary infarction;
diseases of the hypothalamus;
primary hypothyroidism;
polycystic ovary syndrome.

Symptoms of elevated prolactin in women

Symptoms of elevated prolactin in a woman are associated with its ability to block the action of progesterone and estrogen.

One of the signs is delayed sexual development. Patients with this pathology differ from their peers in the absence of menstruation (primary amenorrhea). They also have underdeveloped secondary sexual characteristics. During a gynecological examination, hypoplasia of the internal and external genitalia is noted. They are usually tall with a relatively short body, long arms and legs.

If the hormone prolactin is elevated, a woman may experience irregular menstruation, bleeding, and severe abdominal pain. In some cases, menstruation is absent for six months or longer.

The main function of the hormone is to ensure lactation in women after the birth of a child. Prolactin receptors are present not only in the uterus and ovaries, but also in the heart, kidneys, liver, lungs, spleen and skeletal muscles.

Another possible symptom is breast discharge. The amount of liquid can be from a few drops per day to several milliliters. In severe cases, unauthorized expiration is possible, which causes serious inconvenience to the woman. Most often, discharge appears when pressure is applied to the nipple on one or both sides. They look like a clear liquid or resemble milk. If they change color or there is an admixture of blood, then the cause is not increased prolactin levels. In this case, you should seek additional advice from a doctor.

In almost 60% of women with elevated levels of mammotropin, water retention in the body and the deposition of fatty tissue leads to the fact that they quickly gain excess weight, which is quite difficult to get rid of.

If prolactin is elevated in women, the consequence may be increased male-pattern hair growth. They become very rough and can appear not only on the arms and legs, but also on the face, chest, back and abdomen.

The hormone negatively affects the skin, so women with excessive levels of it often develop acne on the face (in the chin area), on the back or chest.

If the cause of the increased level of mammotropin in the blood is a pituitary adenoma, the patient may experience impaired peripheral vision, double vision, headache and dizziness.

Other signs of hormone imbalance:

Infertility. Since the second phase of the menstrual cycle is shortened, and ovulation may be completely absent, the woman has problems conceiving.
Lack of sexual desire. When prolactin levels are elevated, women often experience sexual coldness. They do not get satisfaction during sexual intercourse.
Decreased memory and impaired concentration.
Multiple dental caries and increased bone fragility. They arise as a result of the leaching of calcium salts from the body.
Emotional disturbances. 20% of women with elevated prolactin levels experience depression, anxiety, and depressive states.

Treatment of elevated prolactin

In order to lower the level of mammotropin in the body, hormonal drugs are used in most cases. They are prescribed by a doctor after determining why the pathology occurred. In cases where a woman has elevated prolactin, the following can be used for treatment:

estrogen antagonists, increasing the sensitivity of receptors to this hormone;
thyroid hormone analogues;
adrenal hormones;
dopamine receptor agonists.

If prolactin is elevated in women as a result of large pituitary tumors that are not amenable to drug therapy, they may be destroyed using ionizing radiation.

When the tumor causes vision problems, it is removed surgically. The operation is performed through the nasal sinuses. If the adenoma reaches a large size, in 20% of cases it may reappear.

If the development of unpleasant symptoms is not observed against the background of an increase in hormone levels, this disorder should not be treated.

The level of mammotropin is influenced by antipsychotics, antituberculosis drugs, antiemetics, opiates and oral contraceptives. After completion/cancellation of therapy it returns to normal.

Consequences of increased mammotropin

The consequence of hormonal imbalance in women may be difficulty conceiving. Irregularity of the menstrual cycle and lack of ovulation against the background of increased levels of mammotropin often lead to infertility.

Miscarriage is also possible. High levels of the hormone cause early miscarriage or premature birth. Blockage of the mammary gland ducts, which occurs against the background of increased hormone levels, can lead to the development of mastopathy or the appearance of cysts.

Other possible consequences:

polycystic ovary syndrome (mammotropin negatively affects ovulation, resulting in cysts appearing in place of mature follicles);
osteoporosis (it can occur due to the fact that calcium is excreted from the body along with milk);
general condition disorders (memory deterioration, sleep problems, inattention).

The hormone mammotropin plays an important role in a woman’s body, therefore, if symptoms are identified that indicate an increase in its amount in the body, it is necessary to seek advice from a gynecologist-endocrinologist.

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Prolactin is a hormone produced by the pituitary gland. It prepares a woman's mammary glands for breastfeeding by stimulating milk production, and also regulates the menstrual cycle and ovulation. Hyperprolactinemia is an increased level of prolactin in the blood, which causes ovulation disorders and cycle irregularity.

Reasons for increased prolactin

There are 2 types of hyperprolactinemia - pathological and physiological.

Pathological occurs in certain diseases:

Diseases of the pituitary gland (brain cysts, prolactinoma, meningioma and others).
Diseases of the hypothalamus (tuberculosis, germinoma, radiation exposure, sarcoidosis and others).
Other diseases (liver cirrhosis, primary hypothyroidism, estrogen-producing tumors, idiopathic (the cause is not clear) hyperprolactinemia and others).

Physiological- when the hormone prolactin increases in a healthy person.

And it happens in such cases:

Breastfeeding (lactation).
Hypoglycemia (hunger).
Sports loads (activity on sports grounds, as well as performing work that involves lifting weights).
Sexual intercourse.

Pregnancy.
Medical procedures (long massage sessions of the neck area, since prolactin levels are controlled by nerve nodes located in the cervical region).
Stimulation of the nipples due to physical stress or poor-quality underwear. Discharge from the nipples of the mammary glands sends impulses to the cerebral cortex and thereby provokes excessive release of prolactin.

An increase in prolactin can also be caused by various medications: antidepressants, estrogens, antipsychotics, amphetamines, opiate drugs.

Symptoms of elevated prolactin in women

Infertility, which is associated with lack of ovulation. Miscarriages also occur in the early stages of pregnancy (up to 10 weeks).
Menstrual irregularities (oligomenorrhea, amenorrhea). The most common symptom, occurring in 60 - 90% of cases: menstruation is rare or absent. Amenorrhea very often coincides with operations, childbirth, the beginning of sexual activity, and the abolition of oral contraceptives.
Galactorrhea is the discharge of milk from the nipples. The longer the disease, the less galactorrhea becomes (in some patients, galactorrhea has been observed for many years). There are three degrees of this disease: third degree - milk is separated spontaneously; second degree - copious discharge when pressing hard on the nipple; first degree - single drops when pressing on the nipple.
Acne or hirsutism is excess hair growth around the nipples, on the face, along the linea alba.
, decreased libido, lack of orgasm.
An increase in body weight is associated with the fact that the hormone prolactin increases appetite and promotes the deposition of nutrients in the body.
Problems with the thyroid gland. Since the general hormonal background of sex hormones changes, the functioning of the thyroid gland is also disrupted.
Prolactinoma. The norm for prolactin in women is from 120 to 500 mIU/l. An excessive increase in this hormone in the blood can lead to memory impairment and vision impairment. This happens because the cells that produce prolactin can increase in size when functioning for a long time. In this case, a benign prolactinoma tumor is formed, which compresses the optic nerves, which leads to deterioration of vision. Prolactinoma is dangerous because it negatively affects the nervous system. Patients experience depression and sleep disturbances.
Osteoporosis. The period of lactation in a woman contributes to the loss of calcium. The hormone prolactin leads to changes in the metabolism of this microelement. Calcium is washed out of bone tissue, which leads to their fragility.

Diagnosis of hyperprolactinemia

Many women are interested in when to take a prolactin test. Diagnosis of elevated prolactin is based on determining its level in blood serum, which must be taken in the morning on an empty stomach. A woman needs to have a good rest and also abstain from sexual intercourse the day before.

In order to establish the true frequency of hyperprolactinemia, it is necessary to measure the hormone level three times. Its meanings are:

120-500 mIU/l. - normal prolactin level in women.
An increase above 200 mcg/l (2000 mIU/l) often means that the patient has prolactinoma.
If the prolactin concentration is 150 mcg/l (1500 mIU/l) or even higher, then dynamic determination of hyperprolactinemia is necessary.

Additionally, thyroid function is examined. In women suffering from kidney disease, it is necessary to determine the level of creatinine in the blood.

At high levels of the hormone prolactin, CTG and MRI of the head are recommended in order to exclude pituitary adenoma.

The diagnosis of pathological hyperprolactinemia is established only after excluding drug and physiological causes.

Treatment of hyperprolactinemia

Treatment for elevated prolactin hormone is to normalize it. With a physiological increase in the hormone, there is no need to think about how to lower prolactin, since it normalizes itself when the causes of hyperprolactinemia (pregnancy, childbirth) are eliminated. But if a pathological increase in prolactin is detected, treatment, of course, should be individual.

The leading place in the treatment of hyperprolactinemia belongs to medications.

There are now three generations of drugs:

Since dopamine suppresses the secretion of prolactin, dopamine agonists (pergolide, bromocriptine) are used.
A new dopamine agonist is cabergoline.
Non-ergotic dopaminomimetic drugs - quinagolide.

Herbal preparations have also found their use: cyclodinone, mastodinone. These drugs are used for mastodynia, benign diseases of the mammary glands, premenstrual syndrome and other conditions in young women.

Bromocriptine is the gold standard in the treatment of hyperprolactinemia, but cabergoline (a third-generation drug) is better tolerated and more effective. Cabergoline can be used only 1 - 2 times a week.

A high-quality generic drug of cabergoline, Alactin, has been produced in Ukraine.

Normalization of the hormone prolactin occurs within 2 to 4 weeks after using these medications.

In addition to drug therapy, surgical intervention is used for treatment

Indications for its use are: tumor growth with symptoms of compression of adjacent structures, pituitary apoplexy, microadenomas. After surgery, the relapse rate is 43%.

Some interesting facts about the treatment of hyperprolactinemia

Hyperprolactinemia is the cause of many benign tumors of the uterus and mammary glands.

Treatment tactics depend on the woman’s reproductive plans and the size of the prolactinoma.
The most effective are third generation agonists (cabergoline).
Bromocriptine treats hyperprolactinemia in women planning pregnancy.
Surgical intervention is a “step of despair” and is used mainly when drug treatment is ineffective.

Both mature (those who have given birth) and young women should control the level of the hormone prolactin. In order not to get sick tomorrow, you need to take care of your health today.

For the success of treatment, as well as to prevent an increase in prolactin in the blood, you need to promptly contact an endocrinologist or obstetrician-gynecologist.