High prolactin symptoms. Causes of increased prolactin production in women. Diagnosis and treatment

Prolactin is a type of hormone. This hormone is produced in the pituitary gland (brain).

If the hormone prolactin is produced in the body in excessive quantities, then this phenomenon is called hyperprolactinemia and is often dangerous to human health.

The hormone prolactin is responsible for the reproductive function, as a result of which it:

• Promotes the formation and development of secondary sexual characteristics.
• It is a regulator of sexual behavior.
• In women during lactation, it prevents ovulation (leading to temporary infertility).
• Responsible for the functioning of the maternal instinct.
• Helps the immune system fight harmful microorganisms.
• Stimulates the balance of substances (calcium, sodium and water) in the body.
• Helps cope with stress.
• Affects weight gain.

Doctors note that the effect of the hormone prolactin is currently not fully studied: it is quite possible that it performs some other functions that are not yet known to medicine.

This hormone promotes lactation by helping colostrum ripen and turn into mature milk.

Thanks to the hormone prolactin, growth, full development and production of female mammary glands are stimulated.

Prolactin is an important element in the process of implantation of a fertilized egg. This hormone also promotes rapid metabolism and helps speed up protein synthesis.

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The level of the hormone prolactin can be determined only through a complex of medical studies:

• MRI of the brain in the area of ​​the pituitary gland and hypothalamus. If the MRI results are insufficient, then additional contrast is performed.
• X-ray of skeletal bones to determine possible irritation in bone tissue.
• Analysis of the general condition of the thyroid gland.
• Ultrasound aimed at examining the condition of certain organs (kidneys, liver, ovaries and mammary glands) to identify possible pathologies.
• If a person is overweight, then the level of cholesterol and blood sugar is additionally determined.
• If pathologies are detected on MRI, an additional examination is carried out by an ophthalmologist.

The normal level of the hormone prolactin varies from 120 to 600 mU/l depending on the age, gender and health status of the person. When the permissible values ​​of the hormone prolactin increase, a person is prescribed treatment.

To determine the concentration of the hormone prolactin, it is necessary to take tests from the 5th to the 8th day of the menstrual cycle.

On the eve of the test, you should try to eliminate any stress and remain in a calm state, since the emotional background significantly affects the test results. The day before the examination, sexual intercourse and exposure to heat (saunas, prolonged exposure to the sun, etc.) are excluded.

To determine the level of the hormone prolactin, blood is taken from a vein, always on an empty stomach. During the day, the level of prolactin in the body changes, so it is better to choose the optimal time: the most reliable tests will be obtained at 8-10 am.

In what cases is it worth getting tested for prolactin?

You should go and get tested for the hormone prolactin when you are concerned about characteristic symptoms. For the female body, such symptoms may include enlarged mammary glands, sudden release of milk in non-pregnant women, irregularities in the menstrual cycle, and lack of ovulation (infertility). In men, the main symptoms may be a decrease in general sexual desire, impotence and infertility, sudden headaches and breast growth.

It is worth noting

Both men and women may be bothered by frequent headaches, a sharp deterioration in vision, a constant state of depression and stress, and weight gain. If a person is diagnosed with a pituitary adenoma, then it is necessary to be tested for the hormone prolactin.

Test results may be unreliable due to the influence of many factors: prolactin could increase due to stress, illness (even a cold), bad mood, etc. During pregnancy, as well as feeding a newborn with breast milk, the hormone prolactin is always produced in increased quantities: this means that during such a period there is no point in taking tests; high prolactin for pregnant women is the norm.

High prolactin: symptoms and consequences

Symptoms of elevated prolactin levels in women include:

• Sudden release of milk from the mammary glands although the woman is not pregnant.
• Hair loss in the genital area.
• Irregularities in the monthly cycle (irregularity, scanty discharge).
• Severe decrease in sexual desire.
• Increased fatigue, problems sleeping, sudden loss of mood.
• Inability to get pregnant: Problems with ovulation prevent you from conceiving a child.
• Problems with the functioning of the thyroid gland, the consequences of which are increased prolactin levels.
• Osteoporosis (also characteristic of low estrogen levels).

Pregnant and lactating women always observe high levels of prolactin: they are characterized by an increased level of prolactin in the blood, which is the norm in this condition.

If you suspect that your symptoms indicate high prolactin levels, be sure to consult a specialist. In this case, you will need to consult a gynecologist and endocrinologist.

The main problem resulting from an increase in prolactin in a woman’s body is the inability to conceive. A significant increase in prolactin levels suppresses the synthesis of certain hormones that contribute to the normal development of ovulation. For this reason, anovulation occurs, when any attempts to conceive a child are in vain.

Consequences of elevated prolactin in men

The manifestation of an increased level of prolactin in men is characterized by a weakening of potency and a lack of sexual desire in general, since there is a decrease in the amount of sex hormones and sperm produced by the male body.

The production of the male hormone (testosterone) decreases and at the same time there is a significant increase in the production of the female hormone (estrogen).

High levels of prolactin in men may indicate the presence of certain diseases. Prolactin will increase in the presence of a pituitary tumor, liver cirrhosis, constant stress, chest damage, etc.

Prolactin can also jump for physiological reasons: exposure to physical activity, lack of sleep, excess intake of protein foods, etc. In this case, prolactin increases temporarily and does not affect the hormonal balance in the body.

With high prolactin in men, the following consequences are possible:

• sleep disturbances, prolonged depression;
• excess weight;
• growth of mammary glands;
• decreased vitality in general;
• Infertility and impotence are possible.

Prolactin and testosterone in the male body are in the following relationship: the more prolactin in the body, the less testosterone is produced. Therefore, the lower a man's testosterone levels, the more different problems prolactin can cause.

Causes of elevated prolactin and how to deal with it

The normal level of prolactin is different for men and women: for example, for non-pregnant women a prolactin level of 4-23 ng/ml will be considered normal, for pregnant women - 34-386 ng/ml, for men - 3-15 ng/ml. In girls and women after menopause, the prolactin level should not exceed 19-20 ng/ml.

Depending on the research methods used in laboratories, the results of laboratory tests may vary: in each specific case they are based on the norm values ​​of the hormone prolactin for a particular laboratory.

Elevated levels of prolactin do not necessarily indicate the presence of any diseases; the hormone can be elevated in completely healthy people.

Reasons for increased prolactin levels:

• Presence of pregnancy, already at 8 weeks of pregnancy the level of prolactin increases significantly.
• Lactation period.
• Severe stress.
• Failure to comply with the rules for donating blood (in connection with existing standards in laboratories).

However, elevated prolactin may be an indicator for identifying certain diseases:

• Prolactinomas are when a tumor develops in the pituitary gland, resulting in the production of excess hormone.
• Hypothyroidism, when the thyroid gland produces too few hormones.
• Anorexia.
• Polycystic ovary syndrome, when the menstrual cycle is disrupted, increased hair growth on the body, infertility may occur.
• Kidney diseases, hypothalamic tumors, etc.

How to reduce prolactin levels

Treatment for elevated prolactin levels depends on how much prolactin is above normal.

If the increase in this hormone is insignificant (up to approximately 50 ng/ml), then prolactin will decrease on its own; you just need to adjust your lifestyle and stop taking medications that cause its increase.

If a woman is pregnant or nursing a child, then prolactin treatment is not required.

In other cases, prolactin levels are reduced to normal using the following methods:

Medication

Prolactin can be reduced by two groups of drugs:

• Ergoline(preparations of ergot alkaloids): treatment is carried out with bromocriptine, lactodel, parlodel, serocryptine, apo-bromocriptine, bromergon, abegrin, dostinex, as well as cabergoline preparations (dostinex);
• Non-ergoline: Treatment is possible with quinagolide preparations (norprolac). Products for reducing the level of the hormone prolactin are produced by large companies that have proven themselves in the pharmaceutical market: Pfizer, Novartis Farma, Apotex, Gedeon Richter, Serono, Lek, etc.

All these products are available in tablets or capsules. Only a specialist can prescribe the drug necessary for your body.

Herbs and folk remedies

Prolactin increases sharply when there is stress in a person's life. In this regard, it is necessary to take medications that eliminate stress. Such remedies in folk medicine include the herbs St. John's wort, hawthorn, elderberry, hops and lemon balm. Decoctions are made from these herbs and drunk in the evening, a couple of hours before bedtime.

Other

To maintain normal prolactin levels, it is necessary to strictly maintain a balance of work and rest. You need to try to minimize strong physical activity, maintain a sleep schedule, and take exercise walks. Coffee and alcohol are excluded from the diet. If the cause of elevated prolactin is the presence of certain diseases in a person, then the disease itself is treated.

Prolactin may decrease on its own without treatment in the following cases:

• The end of pregnancy and the period of feeding the baby with milk.
• Reduce stress levels to a minimum in men and non-pregnant women.
• At the end of puberty in adolescents, when girls have sufficiently developed mammary glands.
• Restoring sleep patterns.
• As a result of the treatment of diseases that provoke an increase in prolactin: for example, treatment of mastopathy (pathological proliferation of connective tissue).

Prevention

There is no special prevention for prolactin: you need to eat right, not self-medicate, and try not to sunbathe too much. If you have problems sleeping, it is better to replace sleeping pills with valerian.

If a woman notices scant discharge from the nipples within two to three years after childbirth or an abortion, then do not worry: this is a normal state of the body during such a period; treatment for elevated prolactin is not required. The main thing is not to squeeze the contents out of the nipple yourself, otherwise prolactin will continue to be produced at an increased level.

Prolactin is a peptide hormone that is produced in the anterior pituitary gland. It belongs to the family of so-called prolactin-like proteins, including placental lactogen, somatotropin (growth hormone) and proliferin.

What is known about prolactin today?

• While breastfeeding. It is believed that this hormone supports the formation of milk during breastfeeding, and during pregnancy it prepares the mammary gland, stimulating the growth of lobules of glandular tissue. By inhibiting ovulation, prolactin ensures the absence of menstruation in a nursing mother and thus protects the woman’s body from the onset of an early new pregnancy after childbirth.
• In the fetus. During pregnancy, prolactin “protects” the embryo from the effects of cells of the maternal body’s immune system, and during the last trimester it prepares the baby’s lungs for the first full breath (participates in the production of a special substance - surfactant, thanks to which the newborn’s lungs do not collapse back).
• Analgesic effect. It is believed that increasing the level of prolactin in the blood helps to lower the threshold of pain sensitivity.
• Providing orgasm during intercourse.
• The largest amount of prolactin in the blood is recorded early in the morning or during REM sleep.

Symptoms of elevated prolactin in women

1. Increased levels of prolactin in the blood (hyperprolactinemia).
2. Discharge of milk from the mammary glands (galactorrhea).
3. Infertility.
4. Violation of the monthly cycle.

Hyperprolactinemia

This is an increased concentration of prolactin in the blood. As a rule, at first a woman does not know that she has an excess of this hormone, but the following symptoms may indirectly indicate this condition:

• Menstrual irregularities. , quite rare.
• Decreased sexual desire. Of course, work, heavy physical activity, and chronic lack of sleep can also reduce libido, but if all these factors are eliminated and the problem remains, hyperprolactinemia should be suspected.
• Growth of mammary glands with the formation of cysts, mastopathy.
• (increased fragility, fragility of bones) with long-term hyperprolactinemia.
• Vaginal dryness, decreased genital hair growth.

Galactorrhea

It occurs when there is a significant increase in the level of prolactin in the blood and is manifested by the release of milk or colostrum from the mammary glands. May be accompanied by engorgement and breast tenderness. It should be remembered that a woman’s milk production is controlled by several hormones, so prolactin is not always “to blame” for this. To identify the exact cause, it is necessary to undergo a detailed examination by a gynecologist.

Infertility

In the case of excess prolactin, everything is very simple: the hormone delays ovulation indefinitely, and without it there can be no conception. As in the case of galactorrhea, it cannot be definitively concluded that unsuccessful attempts to conceive are always associated with prolactin. A timely examination by a gynecologist will in many cases help solve this problem.

Menstrual irregularities

As mentioned above, elevated prolactin levels are characterized by scanty or delayed periods (something similar to what normally occurs in a breastfeeding woman during the first 3-5 months after childbirth).

What to do

Firstly, if you detect any of the above symptoms, you should consult a gynecologist.

Secondly, don't panic. Thanks to the development of modern medicine, today in many cases hyperprolactinemia can be treated quite successfully.

Thirdly, be sure to undergo a full examination prescribed by the doctor. If you need to determine the level of prolactin in the blood, remember that 2 days before the test you need to avoid sweets, physical activity, sex, and taking medications that can increase its level.

Fourth, regularly take medications prescribed by your doctor (for example, Parlodel).

Fifthly, if hyperprolactinemia is detected, do not provoke an increase in this hormone artificially. Remember that certain medications (for example, hormonal contraceptives, antidepressants or tranquilizers) or drugs can significantly increase the concentration of prolactin in the blood for a long time.

Which doctor should I contact?

If you have menstrual irregularities, you should consult a gynecologist. Additional assistance in diagnosis and treatment will be provided by a gynecologist-endocrinologist, endocrinologist, and mammologist.

A woman’s hormonal background affects her well-being and overall health. The endocrine glands synthesize hormones in a certain amount that regulate the functioning of various organs and systems. The anterior lobe of the pituitary gland produces prolactin, which largely determines the functionality of the woman’s reproductive apparatus.

The concentration of prolactin is not a constant value. An increase in hormone levels during pregnancy, as well as before menstruation, is considered physiologically normal. But hyperprolactinemia can also be a sign of pathological conditions in the body. Therefore, it is very important to find out the causes of the problem and, if necessary, take measures to correct the hormone level.

Functions and role of prolactin

There are receptors for this substance in almost every organ. Most cells with hormone receptors are found in the mammary glands. It is he who determines the production of milk in women during lactation.

Other functions of prolactin include:

• promotes the formation of mammary glands during puberty;
• increases the number of ducts in the glands, promotes the growth of glandular lobules;
• inhibits ovulation during pregnancy and after it;
• prevents the embryo from being rejected by the mother’s immune system;
• reduces the pain threshold;
• promotes orgasm during sexual intercourse.

Norm of indicators

To find out the concentration of prolactin, women need to donate blood from a vein in the morning on an empty stomach no earlier than 3 hours after getting up. The day before, you should avoid sexual intercourse, stress, and physical activity. The day before the test, do not go to the sauna or bathhouse.

Reasons to get tested for prolactin may include:

• , which does not relate to lactation;
• disruptions of the menstrual cycle;
• inability to become pregnant for a long time;
• decreased libido.

The norm for prolactin in women in the absence of pregnancy is 4-34 ng/ml. Depending on the phase of the cycle, the hormone should be within the following limits (ng/ml):

• follicular phase - 4.5-23;
• ovulation - 5-34;
• luteal phase - 4.9-30.

If pregnancy occurs, the indicators will be as follows (by trimester in ng/ml):

• 1 - 3,2- 43;
• 2 - 13-166;
• 3 - 13-318.

An increase in hormone levels occurs from the 8th week of pregnancy. Its concentration peaks at 20-25 weeks.

If it is detected, additional studies are prescribed that will make it possible to find out its causes and correctly prescribe treatment. It is recommended to do kidney, adrenal gland, MRI or CT scan of the brain, laboratory tests to determine hormonal status, blood biochemistry.

On a note! High prolactin affects the condition of the entire body. Almost all organs are affected. It is important to promptly record symptoms indicating hormonal imbalances and seek help from a specialist.

Causes and symptoms of elevated hormone levels

Depending on the nature of origin, they are divided into physiological and pathological.

Physiological factors for the development of hyperprolactinemia include:

• breastfeeding period;
• increased physical activity;
• poor nutrition associated with strict food restrictions;
• high protein content in the diet;
• wearing tight underwear and frequent breast palpation;
• sexual intercourse;
• stress;
• massage of the collar area, irritating the nerve fibers.

Pathological hyperprolactinemia is caused by:

• ( , cyst, );
• anorexia;
• brain injuries;
• kidney disease;
• liver cirrhosis;
• addiction.

Separately, we can distinguish iatrogenic hyperprolactinemia, which occurs during treatment with certain groups of drugs:

• antidepressants;
• estrogens;
• antihypertensive drugs;
• neuroleptics;
• antiemetic drugs.

Signs and symptoms of elevated prolactin:

• galactorrhea (discharge of milky fluid from the nipples);
• decreased libido;
• increased body hair growth ();
• skin rashes;
• excess weight due to excessive appetite;
• decreased vision;
• menstrual irregularities;
• fast fatiguability;
• depressive states.

Possible consequences for the body

Any hormonal imbalance is fraught with various complications. Elevated levels of prolactin also pose certain threats to women's health. Almost every woman suffering from cycle disorders and infertility experiences hyperprolactinemia. This may be a harbinger of tumor formations in brain structures (pituitary gland, hypothalamus).

Significant upward jumps in the hormone level are fraught with a number of dangerous conditions for a woman:

• Sexual dysfunction - lack of orgasms, frigidity.
• - high prolactin blocks the synthesis by the pituitary gland and, which control the functioning of the ovaries. As a result, periods become scanty and over time they may disappear completely.
• Secondary or primary infertility - hyperprolactinemia suppresses the ovulation process. As a result, the egg is not released from the follicle and cannot be fertilized.
• Osteoporosis - excess prolactin contributes to the leaching of calcium from bone structures. Bones become brittle and often fracture.
• Tumor formations in the breast - if significant growth of the mammary glands appears, pain appears, this may be an alarming signal.
• - increased appetite and obesity, as a consequence of impaired carbohydrate metabolism, lead to impaired levels.
• Psycho-emotional disorders - depression, psychosis, social maladjustment.
• Metabolic disorders increase the risks of developing hypertension and coronary artery disease.
• Visual impairment - often occurs if hyperprolactinemia is associated with pituitary tumors. The formation puts pressure on the eye endings, causing the problem.

Find out about the symptoms in men, as well as the treatment of the pathology.

The rules and features of using Mamoclam tablets for the treatment of mastopathy of the mammary glands are described on the page.

Effective treatments

A doctor can prescribe treatment only after establishing the cause of increased prolactin. With physiological hyperprolactinemia and a slight jump in hormone levels, no special treatment is required. If the problem is caused by pathological changes in the body, then individual therapy is prescribed, depending on the cause and severity of the pathology. It is important for a woman to restore ovulation, especially if she plans to have children.

Among the drugs used to combat hyperprolactinemia, drugs containing ergot alkaloid are highly effective:

• Cabergoline;

The course of taking such medications can last for several years. Sometimes you have to take medications for the rest of your life. The dosage of drugs can be adjusted based on the results of control tests.

In the presence of tumor formations that provoke an increase in prolactin, surgery and radiation therapy are recommended. Access to the tumor is usually carried out transnasally. Today, craniotomy is used extremely rarely.

Diet and nutritional habits

With slight increases in prolactin, you can adjust its level by changing your diet. It is very useful to eat foods fortified with folic acid. It helps to quickly absorb proteins, the excess of which often causes hyperprolactinemia.

• fatty fish;
• liver;
• eggs;
• spinach;
• parsley;
• flax seeds;
• nuts.

It is essential to limit the consumption of foods high in gluten, preserved foods, and smoked foods.

There are no specific preventive measures against hyperprolactinemia in women. To minimize the risks of increased prolactin in the blood, it is recommended:

• maintain a healthy diet;
• engage in moderate physical activity;
• give up bad habits;
• have sexual intercourse with one partner;
• avoid stressful situations;
• undergo a preventive examination with a gynecologist 1-2 times a year.

An increase in prolactin in a woman’s body can be a natural condition during pregnancy and breastfeeding. But there are situations when the symptoms of hyperprolactinemia arise due to the presence of certain pathological changes. You can’t ignore the signals your body gives. It is important to be examined promptly and, if necessary, correct the condition.

The video is a fragment of the TV show “Live Healthy!”, from which you can learn more useful information about the causes and treatment of elevated prolactin, as well as the likely consequences of hyperprolactinemia for women::

Elevated prolactin is a problem that is not talked about on every corner, although it deserves due attention. All this is explained by the fact that an increase in this hormone can mean both illness and a normal physiological state. To understand all this, you must first understand what prolactin is and what role it plays in the human body.

So, prolactin is a protein hormone responsible for many biological processes in the human body, but it is especially important for women. This substance is also secreted in men, but scientists have not yet been able to find out how important the role it plays in the male body. It is produced in a small organ located in a bone formation called the sella turcica and located on the lower surface of the brain. It has two names - the pituitary gland or the pituitary gland.

Prolactin is produced in its anterior part, like some other hormones (somatotropin, thyrotropin, adrenocorticotropic hormone). In addition, it is produced in much smaller quantities in the endometrium of the uterus, skin, intestines, kidneys, liver and adipose tissue.

Interesting to know: Prolactin has other names: mammotropic or luteotropic hormone (LTH).

The amount of mammotropin needed by the body is controlled by dopamine; this hormone has an inhibitory effect on the secretion of mammotropin by the pituitary gland. Normally, prolactin reacts with a slight increase in many aspects of life. Sleeping and eating, heavy physical work and psycho-emotional stress, nipple irritation and sex - all this leads to an increase in LTG circulating in the blood. That is why the normal limits for prolactin are extremely wide and range between 40 and 500 mU/l, and even exceeding the upper limit by 40-50 units is not considered pathological in most cases.

Interesting to know: A condition in which prolactin is elevated in a person’s blood is called hyperprolactinemia. After ovulation, the concentration of LTG in the female body normally increases.

Why does luteotropic hormone increase?

All causes of increased prolactin can be divided into two groups:

1. physiological;
2. pathological.

Some reasons for the physiological increase in mammotropin have already been described above, so let’s move on to those that we have not yet talked about. So, prolactin is high during pregnancy and breastfeeding. All this is easily and logically explained: during pregnancy, LTG prepares the expectant mother’s breasts for lactation, and after childbirth, it actively stimulates the production of milk for the baby in the mammary glands.

Interesting to know:

Newborn babies may also experience increased prolactin, regardless of their gender, and a few drops of whitish fluid may even be released from the baby's mammary glands. This is considered normal, is called a sexual crisis and is associated with the entry of the mother’s sex hormones into the child’s body during childbirth.

It is worth dwelling in more detail on the pathological causes of increased prolactin; they can be divided into two groups: hyperprolactinemia, which develops in response to diseases of the internal organs and pituitary gland, and iatrogenic increase in LTG.

Perhaps it’s worth starting with iatrogenic hyperprolactinemia, which develops as a result of taking medications. This can be considered a side effect of therapy and, if the increase in luteotropic hormone is not accompanied by pathological symptoms, then discontinuation of the drug is not required; a more correct solution would be to adjust the dose. A transient increase in mammotropin occurs after operations under anesthesia.

Interesting to know:

Increased prolactin is observed when taking estrogen contraceptives, antidepressants, antipsychotics, antiparkinsonian and antiemetic drugs, some antihypertensive and antiarrhythmic drugs.

Drugs and alcoholic beverages also cause significantly elevated prolactin levels.

There is a concept of idiopathic hyperprolactinemia, when, despite all possible research methods, it is not possible to find out the cause of the increase in LTG.

Elevated prolactin can be observed in diseases such as liver cirrhosis and chronic renal failure, as well as in cases of serious injuries to the chest organs, extensive burns of this area, and diseases of the thyroid gland. Diseases of the female reproductive system also lead to pathological hyperprolactinemia (polycystic ovary syndrome, endometriosis, fibroids and inflammatory lesions of the appendages). In some cases, increased prolactin indicates direct damage to the hormonal structures of the brain (hypothalamus) and pituitary gland, with all the ensuing consequences. This is possible in the presence of tumors or metastases in the brain or as a result of the damaging effects of neuroinfections (tuberculosis, syphilis, etc.).

What symptoms indicate increased LTG?

In women, the first sign of this pathology will be a change in the nature of menstruation: their duration decreases, the length of time between menstruation increases, they may become more or less abundant than before. If a woman regularly checks her basal temperature, she may find that ovulation is not occurring. This is due to the ability of mammotropin in high concentrations to suppress the maturation of the follicle and the release of the egg from it. Thus, one of the severe consequences of hyperprolactinemia is infertility.

Interesting to know:

It is this property of LTG that normally causes lactational amenorrhea during breastfeeding. This is a natural method of contraception in the postpartum period, however, its reliability is high only if the intervals from one feeding of the baby to the next last no more than four hours.

A woman may also be bothered by dryness of the vaginal mucosa, which especially causes discomfort during sexual intercourse and decreased libido.

If a woman is not pregnant or breastfeeding, then the discharge of milk or similar fluid from the mammary glands will also be a symptom of increased prolactin. The severity of this symptom is usually not related to how high it is at the moment, and can manifest itself either as the appearance of several whitish drops when the nipple is squeezed, or as a stream of milk from the breast. This symptom in medicine is called galactorrhea and may be accompanied by some increase in the volume of the mammary glands or a feeling of discomfort in them.

If the cause of increased prolactin is a mass formation in the pituitary gland or in the area adjacent to it, then the patient may experience dizziness, prolonged headaches, frequent mood swings, decreased vision, as well as osteoporosis or periodic increases in blood pressure for unexplained reasons.

Men may also experience some of the above symptoms: galactorrhea, decreased libido, vision problems and headaches, and enlargement of the mammary glands in the stronger sex is called gynecomastia.

Necessary research

If you discover any signs of increased prolactin, you should definitely consult a doctor, and sometimes even several, as this can be caused by troubles in various body systems. Both men and women can first contact an endocrinologist and, together with him, determine what other specialists are needed. When communicating with a doctor, you need to answer as meaningfully as possible; if you are constantly taking any medications, you need to indicate which ones.

The range of studies that are prescribed for elevated prolactin is very wide and varied, but naturally, you need to start with a basic blood test for mammotropin.

Interesting to know:

Women should note which day of the menstrual cycle the blood was donated.

You will also need to check:

1. level of sex and thyroid hormones;
2. indicators of liver and kidney function.

In the future, it may be necessary to carry out such instrumental methods as:

• craniogram;
• ultrasound examination of internal organs;
• perhaps even an MRI of the head;
• In some cases, doctors use stress tests.

How to treat hyperprolactinemia?

Treatment for this condition is prescribed depending on the cause of the increase in mammotropin. Curing inflammatory diseases of the female genital organs or kidney transplantation for renal failure can reduce LTG without specific medications. However, in the case when increased prolactin is a consequence of pituitary gland adenoma, it will not be possible to do without medication, and sometimes there is even a need for surgical intervention.

Medicines used to reduce prolactin concentrations are relatively safe and can be prescribed during pregnancy if necessary. An example of such a drug is bromocriptine; when taken, prolactin levels decrease quite well; sometimes treatment with this drug helps to avoid surgery.

endocrinologist, Ph.D.

Prolactin is one of the most mysterious hormones in the body. Its name reflects the most striking effect of its increase - lactation, that is, the secretion of milk in the mammary glands of women after the birth of a child. In fact, prolactin is either responsible for breastfeeding or is a stress hormone.

For reference: Hyperprolactinemia is a condition in which the level of prolactin in the blood is increased. Prolactin is secreted by the pituitary gland, a gland located in the very center of the brain, which is the most important or “controlling” endocrine gland of the body. Lactotroph cells are located in the anterior lobe of the pituitary gland, and their activity is controlled by a substance - dopamine.

So, what happens in the body if the level of prolactin in the blood is really very high?

Among women This leads to suppression of the hormones that control the menstrual cycle (LH and FSH), resulting in periods becoming irregular or stopping completely. In addition, lactation not associated with childbirth may occur.

In men hyperprolactinemia causes a decrease in the concentration of male sex hormones, and can cause erectile dysfunction and decreased libido.

Increased prolactin in children is detected extremely rarely, and if this is a true increase in prolactin caused by a pituitary tumor, then the manifestations may be delayed growth and sexual development.

Hyperprolactinemia is quite common. Among the general population, the incidence of this disease is 0.4%, and among women with infertility - 9-17%. Most often, this problem is detected in women 25-34 years old, but there is reason to believe that this is due to the fact that it is at this age that manifestations of excess prolactin have symptoms in the form of menstrual irregularities and problems with pregnancy.

It should also be noted that prolactin in our body varies. Monomeric prolactin is active, and it is its increase that, as a rule, leads to consequences in the form of all of the above symptoms. Macroprolactin, which is large prolactin molecules consisting of several “small” ones, is an inactive hormone. It has no effects, and in most cases, if there are no manifestations, does not require treatment. Most laboratories now use kits that distinguish macroprolactin from monomeric prolactin, and then this is indicated as a separate item in the analysis result.

How is an increase in prolactin expressed in numbers?

Different laboratories may specify different units of measurement. The most “standard” units are mU/l, when expressed in which prolactin should be no more than 400. An increase within 1000 mU/l is insignificant. From 1000 to 2000 it really begins to be alarming, and more than 5000 is the level that occurs with pituitary tumors. You can often find prolactin expressed in ng/ml, then its highest normal value is about 30.

Thus, if the examination revealed moderately elevated prolactin, then, first of all, the analysis should be repeated. If we are not talking about a significant increase (more than 1000 mU/l), then we can talk about the problem of hyperprolactinemia only after 3 tests, passed correctly in accordance with all the rules. A significant increase (more than 2000 mU/l) in most cases requires an MRI of the brain. Again, the analysis must be done correctly.

The following reasons often lead to a moderate increase in prolactin - less than 1000 mU/l:

• pregnancy;
• the postpartum period (which can last about a year);
• stimulation of the mammary glands (breastfeeding, injury or intimate relationships);
• physical stress (for example, active training on the eve of the test) or psychological (for young children, the very act of drawing blood from a vein often becomes such stress);
• food - after eating, the level of this hormone increases;
• the level of prolactin in women strongly depends on the phase of the menstrual cycle, all of the above norms refer to the first phase, or more precisely to the period from 2 to 7 days of the menstrual cycle; Prolactin does not have a norm for other phases of the cycle except the first, so its study in the middle or at the end of the cycle is not always inherently correct. In men, the level of this hormone is stable and practically does not change.

Moderate and sometimes significant increases in prolactin may be a consequence of other diseases. These include :

• hypothyroidism (thyroid hormone deficiency);
• polycystic ovary syndrome in women;
• chronic severe kidney and liver diseases;
• Celiac disease (possibly).

Prolactin may increase when taking the following medications:

• dopamine receptor antagonists (neuroleptics, metoclopramide, domperidone, etc.), methyldopa, antidepressants (tricyclic, from the group of MAO inhibitors and serotonin reuptake inhibitors), opiates;
• verapamil, bezafibrate;
• omeprazole, some antiallergic drugs;
• sex hormones (contraceptives, testosterone preparations) and their antagonists.

An increase in prolactin can accompany various serious conditions - injuries, fractures, conditions after radiation, radiation or chemotherapy, after an attack of seizures, etc.

The most rare cause of increased prolactin is pituitary tumor– prolactinoma. Small adenomas up to 1 cm in diameter are most common - about 90% of cases. Large ones are much less common. In addition, any brain tumor that displaces the pituitary infundibulum - structurally it connects the pituitary gland and the hypothalamus - will lead to a significant increase in prolactin, since it is through the pituitary infundibulum that the substance dopamine, a natural inhibitor of prolactin production, enters.

The main indications for determining the level of prolactin are menstrual irregularities, infertility in both women and men, lactorrhea (in women). There are many reasons for determining this hormone, but if they do not belong to the above “main” ones, then it is better to consult with an endocrinologist about the need and advisability of studying prolactin.

Treatment of hyperprolactinemia should only be carried out in conjunction with an endocrinologist. Very often, a patient with elevated prolactin is monitored by two doctors at once, for example, a gynecologist and an endocrinologist. Not all cases of elevated prolactin, especially if it is a slight increase, require therapy.

Doctor's advice:

• If you have accidentally detected an increase in prolactin, you first need to make sure that the test was done correctly, then find out whether it recurs.
• In any case, if prolactin increases, it is better to consult with a general practitioner or endocrinologist about whether any further examinations and actions are required.
• Prolactinomas are one of the rare tumors that can disappear with proper treatment with drugs; in a third of women, small prolactinomas can go away on their own after the birth of a child or during menopause.
• An already identified prolactinoma should never be left unattended - even if it is not found after long-term treatment, further observation and verification of the fact that the disease has not returned is required.