If the hormone prolactin is elevated. Elevated prolactin in women

Prolactin is a hormone of the pituitary gland, therefore it has great importance in women's lives. It is he who provides normal functioning reproductive system. Prolactin is responsible for the possibility of procreation: breast formation during puberty, production breast milk after the birth of the child. Therefore, it is necessary to occasionally check the level of the hormone in the blood to prevent the development of possible pathologies.

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The role of prolactin in a woman’s body

Prolactin is produced in the anterior pituitary gland. Specific lactotropic cells participate in its formation. The mammary glands, immune system and even the placenta are also responsible for the production of the hormone. An important role is played by the concentration of estrogen and dopamine in a woman’s body. Prolactin increases when dopamine levels decrease. If the amount of estrogen in the blood increases, the value of the hormone decreases.

Prolactin performs complex tasks and is able to provide normal function reproductive system:

responsible for milk production during lactation;
has a direct impact on development and growth female breast during puberty;
the hormone takes part in metabolic processes amniotic fluid, regulates its composition and quantity;
able to block pregnancy during breastfeeding;
ensures ovulation in the postpartum period;
affects the production of progesterone, which is responsible for ovulatory processes;
regulates menstrual cycle;
takes part in the functioning of the immune system and fat metabolism;
ensures normal functioning of the kidneys;
increases libido.

What threatens an increase in hormone levels in the blood?

If prolactin in the blood reaches values above permissible norm, this condition is called hyperprolactinemia. This disease leads to consequences. A woman may lose sexual desire and experience disruptions in her menstrual cycle. The most serious consequences If prolactin is elevated, infertility is considered.

Hyperprolactinemia has a bad effect on the development of the mammary glands and internal genital organs. This condition can affect the formation of tumors.

Elevated prolactin dangerous for men too. It is responsible for the production of testosterone, and accordingly for the number and activity of sperm. All this can lead to the development of infertility in men.

Causes of hyperprolactinemia

The reasons why the level of prolactin in the blood rises are usually divided into physiological and pathological. Physiologically, the hormone can be elevated even in healthy person. During the day its level changes. This happens unnoticed and depends on what exactly the person is doing. During sleep, the amount of the hormone usually decreases; during exercise or when eating, it increases. This condition is considered normal. In healthy people, an increase in prolactin levels may occur in the following cases:

heavy physical activity before taking the test;
severe stressful situations;
frequent alcohol consumption and uncontrolled smoking;
recent sexual intercourse;
prolonged fasting or eating few calories;
predominance of protein foods in the diet;
pregnancy and lactation period.

In a healthy person, prolactin can increase by no more than 15% of the permissible norm. This condition does not affect women Health And reproductive system. If the cause of the increase in prolactin is not physiological factors, one should suspect the presence in the body pathological process.

It is customary to divide pathological hyperprolactinemia into functional and organic. The second type can be caused by brain tumors. The most common formations are found in the pituitary gland and hypothalamus. These include:

prolactinoma;
glioma;
meningioma;
pituitary adenoma.

Functional pathology develops as a consequence of ailments already existing in the body. These include:

tuberculosis;
cirrhosis of the liver;
renal failure;
sarcoidosis;
hypothyroidism;
polycystic ovary syndrome;
chest injuries.

Often, an increase in prolactin levels in the blood is caused by long-term use some medicines or narcotic substances. These include:

antihypertensive drugs that help lower blood pressure;
antidepressants;
dopamine blockers;
some hormonal contraceptives;
opiates (codeine, morphine, heroin);
cocaine.

Symptoms

Elevated prolactin in women is manifested by the following symptoms:

1. Menstrual irregularities. Menstruation may be scanty or completely absent. Frequent delays may occur.
2. Lack of ovulation. As a result, infertility develops. The egg is not fertilized due to lack of ovulation.
3. Spontaneous miscarriage is possible up to 12 weeks.
4. Severe engorgement of the mammary glands. Usually occurs in the second half of the menstrual cycle. With increased prolactin discomfort may persist throughout the entire cycle.
5. Colostrum discharge from the nipples not associated with breastfeeding. This condition is commonly called galactorrhea.
6. Excess body hair, acne.
7. Decrease or complete absence sexual desire.
8. Metabolic disorders. Increased appetite which leads to overeating and excess weight.

Features of hyperprolactinemia in women

Fluctuations in prolactin levels can occur throughout the menstrual cycle. But it should increase only in the ovulatory phase. On other days, the amount of the hormone should not exceed the maximum permissible values.

Pregnancy is an exception to the rule. In this case, especially in the third trimester, prolactin is several times higher than normal. This is due to increased production of estrogen. Before the baby is born, the hormone levels decrease slightly. After childbirth, it increases again due to the fact that it is directly involved in the formation of lactation.

In women, prolactin increases several times more often than in men. This is due to the fact that they are much more susceptible to the development of certain pathological processes. These include:

polycystic ovary syndrome;
uterine fibroids;
breast tumors.

Brain tumors are common in women. These include small benign prolactinoma. Women of childbearing age suffer from this disease.

Consequences of increased prolactin

In addition to irregularities in the menstrual cycle, lack of ovulation and problems conceiving a child, many women experience other symptoms. These include:

Giant breast syndrome. If the breasts become very hard and painful, this often leads to the appearance of cysts and even oncology. It is possible to release milk without being pregnant.
Frigidity, which has a bad effect on relationships between partners.
Psycho-emotional disorders.
Metabolic disruptions that lead to the development coronary disease hearts.
Obesity.
Diabetes mellitus type 2.
Osteoporosis, which develops due to a decrease in bone mineral density.
The emergence of autoimmune diseases.
Memory, sleep disturbances, fast fatiguability, apathy.
Disorders of the autonomic nervous system.
Irregularities at work thyroid gland.

If hyperprolactinemia is caused by a pituitary adenoma, a woman may experience vision problems. Its sharpness decreases and the angle of the visual field is limited.

Is pregnancy possible with elevated prolactin?

When planning pregnancy, many women are faced with the problem of increasing prolactin levels in the blood. In this case, conception does not occur until the amount of the hormone decreases.

Non-pregnant girls should not be upset, because the right and timely treatment in most cases it helps to give birth to a child. It often takes about a year for therapy and preparation for conception.

Diagnosis of the disease

If a blood test reveals increased level prolactin, it is necessary to find out what could cause this condition. The prescribed treatment will depend on this.

Diagnosis of the disease. To do this, you need to take a blood test from a vein. For more exact result This study is carried out three times. You should prepare in advance for the test:

one day before the study there should be no sexual intercourse;
physical activity should be limited and stressful situations should be avoided;
do not drink or smoke the day before the test;
Blood must be donated only on an empty stomach, preferably in the morning, since closer to lunch the level of the hormone in the blood rises.

Normal prolactin levels in women reproductive age(non-pregnant and non-lactating) should be 40-530 mIU/l. An excess of 1200 mIU/l indicates the development of a pituitary adenoma.

Treatment

Treatment of hyperprolactinemia involves taking medications. If this does not bring results, radiation therapy is prescribed or a decision is made to surgical intervention. Such operations are performed transnasally, without craniotomy. Radiation therapy is prescribed in cases where the pituitary tumor becomes malignant.

Drug treatment is based on taking drugs based on ergot alkaloid. The most famous among them are Cabergoline and Bromocriptine. The course of treatment is always long, sometimes up to 3 years. This therapy is often combined with taking hormonal contraceptives. The well-known drug Dostinex will help lower the level of prolactin in the blood.

Traditional methods

Exist traditional methods combating elevated prolactin. But they are only suitable in cases where the hormone level is slightly increased. If a woman has prolactinoma, no folk remedies cannot be used as primary treatment.

Decoctions and infusions are made based on herbs: hops, motherwort, mint, cinquefoil, lemon balm, valerian. Therapy is prescribed only by a doctor, since self-medication in in this case often only makes the situation worse.

Reduced prolactin

There are cases when a reduced amount of prolactin is found in the blood. This indicates a post-term pregnancy or Sheehan syndrome, in which insufficient production of the hormone occurs in the pituitary gland. This symptom manifests itself as amenorrhea, lack of lactation, spontaneous termination of pregnancy.

Will help raise prolactin levels herbal teas based on raspberries, sage and sweet clover. But before treatment, you should definitely consult with your doctor about the advisability of traditional methods.

As such, there is no prevention of the disease. Correct treatment significantly improves the situation and helps a woman become pregnant.

Prolactin is one of the main hormones of the pituitary gland. Its effect on the body cannot be overestimated.

Prolactin regulates fat metabolism, immune system and kidney function.

Hormone functions in women:

stimulates the growth of breast tissue;
stimulates the development of ducts in the gland;
participates in the formation and maintenance of breast milk secretion;
supports normal course pregnancy;
participates in the emergence of maternal attachment to the baby;
suppresses the maturation of eggs in nursing mothers.

In men, prolactin:

supports testosterone secretion;
stimulates sperm maturation.

If too much of the hormone is produced, a state of hyperprolactinemia develops. High levels of prolactin occur normally and in various diseases.

Normal prolactin levels

To detect hyperprolactinemia, carry out laboratory test- determination of hormone concentration in the blood.

The hormone reacts very strongly to emotional mood and the patient's well-being. Excess prolactin can be detected in a completely healthy person if stress factors influenced the body on the day of the test and the day before.

Causes of functional hyperprolactinemia:

psychological stress;
active physical exercise;
fear of a medical institution;
pain;
sleep disturbance;
sexual intercourse;
a hearty dinner;
smoking;
starvation.

To exclude an increase in the hormone due to these random effects, it is advisable to measure the indicator at least twice on different days.

The norm for prolactin in women is 40–530 mU/l, and in men - 53–400 mU/l. During some periods of women, the level of the hormone increases significantly.

The normal reasons for an increase in the hormone are pregnancy, childbirth and breastfeeding. Why is prolactin measurement not recommended during these periods? This is due to the fact that standards for these patient groups have not been approved.

Signs of elevated prolactin levels

Symptoms of increased prolactin are detected when the hormone level is from 1000 mU/l.

Signs of high blood hormone:

increase in the volume of the mammary glands;
discharge of colostrum from the breast;
weight gain;
decreased sex drive;
impotence in men;
cessation of menstruation in women;
infertility;
bone fractures with minimal trauma;
multiple caries;
high blood sugar;
constant depressed mood;
sleep disturbance.

What diseases cause prolactin to increase?

Pathological hyperprolactinemia is 10 times more common in women than in men.

The main reasons for increased prolactin:

pituitary adenoma;
brain tumors;
chest injuries;
polycystic ovary syndrome;
renal failure;
cirrhosis and liver cancer;
hypothyroidism

Besides, medicinal substances and drugs can lead to increased blood prolactin concentrations.

The hormone levels are most affected by:

antidepressants (imipramine, amitriptyline, haloperidol);
dopamine blockers (sulpiride, metoclopramide, domperidone, antipsychotics);
antihypertensive drugs (reserpine);
drugs against arrhythmia (verapamil);
estrogens (including contraceptives);
opiates (morphine, heroin, promedol);
cocaine.

Diagnosis of elevated prolactin

Revealed high level The hormone prolactin is the cause for mandatory examination see an endocrinologist.

Diagnosis usually begins with repeated determination of prolactin concentration. If hyperprolactinemia persists, an in-depth examination is recommended for the patient.

To search for a tumor that secretes prolactin, an X-ray of the skull in a lateral projection, magnetic resonance imaging or computed tomography is performed.

The adenoma is best seen on a magnetic resonance imaging scanner. It is advisable to examine small neoplasms using contrast agents. These solutions are administered intravenously. Contrasts contain a large number of iodine, so they are contraindicated if you are allergic to this chemical element and for diseases of the thyroid gland.

X-ray examination has low sensitivity. It can only help diagnose a large pituitary tumor.

Signs of adenoma on an x-ray:

destruction of the wall of the pituitary gland;
double contour of bone tissue.

What tests should be performed for hyperprolactinemia?

If prolactin is elevated, the patient should have thyroid function examined. To do this, it is recommended to test thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4). High TSH speaks in favor of hypothyroidism. This disease may cause hyperprolactinemia.

Also, with high prolactin and pituitary adenoma, it is necessary to determine the level of all tropic hormones in the blood. These substances affect the functional activity of all endocrine glands. Tropic hormones are secreted by the pituitary gland. With hyperprolactinemia, there can be either an increase in their concentration or a decrease.

adrenocorticotropic (ACTH);
somatotropic (STG);
follicle-stimulating (FSH);
luteinizing (LH).

Additionally, the patient is prescribed blood biochemistry tests. Doctors are interested in metabolic rates and kidney and liver function.

Hyperprolactinemia can cause high levels of:

blood sugar;
cholesterol;
triglycerides;
bilirubin;
creatinine;
urea.

Why exactly this or that indicator changes is determined by medical specialists (therapist, nephrologist, gastroenterologist).

In some cases, a patient with high levels of the hormone is recommended to study an immunogram.

Ultrasound for high prolactin

Ultrasound can help:

establish the cause high concentration prolactin;
consequences of hyperprolactinemia.

Patients are prescribed an ultrasound of the mammary glands. In men, this study confirms the presence of a large volume glandular tissue. In women, many milk ducts are diagnosed, with an active blood supply to the tissue.

Ultrasound of the thyroid gland is prescribed if hypothyroidism is suspected. During the study, a decrease in the size of the organ, a heterogeneous tissue structure, and a low number of blood vessels may be detected.

Ultrasound of the gonads provides a lot of information when prolactin levels are high. In men, the test often reveals a decrease in the size of the testicles. In women, an ultrasound can be diagnosed with polycystic ovary syndrome, a decrease in the thickness of the endometrium.

Treatment of patients with high prolactin

High prolactin requires monitoring or active treatment.

When can you get by with just follow-up visits to an endocrinologist?

Treatment of elevated prolactin is not carried out if:

hormone concentrations up to 1000 mU/l;
normal structure of the pituitary gland;
preserved function of the reproductive system;
normal body weight.

If patients have symptoms of increased prolactin or a pituitary adenoma is detected, then therapy is mandatory.

The most effective remedy- tablets based on ergot alkaloid. There are two main drugs - cabergoline and bromocriptine. The doctor selects the dose individually, taking into account body weight and the level of the hormone in the blood.

Ergot alkaloids bring the hormone concentration back to normal within 1–2 months. A big plus of these drugs is their ability to reduce the volume of pituitary tumors. Treatment is prescribed for a long period (12–36 months).

In the event that the adenoma is insensitive to treatment with cabergoline and bromocriptine, the option of surgery or radiation treatment. Both methods are quite effective, but damage the pituitary gland tissue and brain vessels.

Folk remedies in medical institutions not recommended. The safety of such treatments has not been studied. A dangerous consequences people's councils can be quite large. First of all, self-medication prevents patients from receiving effective medical care on time.

With pathological hyperprolactinemia, when increased levels of the hormone are not detected during pregnancy or lactation, disturbances in the genital organs and reproductive function of a person may be observed.

What is prolactin for?

This is a hormone of the anterior pituitary gland. Its synthesis increases during pregnancy. It influences preparation mammary glands to feeding, together with progesterone supports activity corpus luteum pregnancy, which is important for maintaining pregnancy.

Subsequently, the hormone regulates the production of colostrum and further milk. Elevated levels of prolactin in the blood remain until the end of feeding.

Prolactin and pregnancy

Hyperprolactinemia is one of the factors that prevent pregnancy. So if a woman is breastfeeding, her chance of getting pregnant is very low. Well, if prolactin is elevated for another reason, then women often go to the doctor complaining of difficulties conceiving.

Is it possible to get pregnant with elevated prolactin? Many women are interested in it. The answer to this question is ambiguous, since it depends on the level of the hormone and on the reasons that caused its increase.

Increasing prolactin by feedback causes a decrease in the synthesis of follicle-stimulating and luteinizing hormones. Insufficient synthesis of FSH and LH causes disruption of the reproductive function of women. In particular, there is a delay in menstruation, absence or irregularity.

All this occurs due to insufficient hormonal support necessary for egg maturation and ovulation. An immature egg, even if ovulation occurs, is usually incapable of fertilization and dies.

When prolactin is elevated, other symptoms occur:

decreased sexual desire;
galactorrhea or abnormal secretion of milk or colostrum;
hirsutism - hair in women grows on the face and chin, like in men;
the appearance of pimples, acne and inflammation of the sebaceous glands;
metabolic disorders (osteoporosis, obesity and hyperinsulinemia);
psycho-emotional disorders (mood changes, headaches and depression).

Milk secretion with hyperprolactinemia is observed in 30% of women, in the rest this symptom is absent, so you need to pay attention to such disorders as the regularity of the menstrual cycle.

Changes in the mammary glands, their enlargement, and discharge from the ducts should also alert you.

This symptom should be a reason to consult a doctor, especially since elevated prolactin can not only cause infertility, but also miscarriage. So, his increase by early stages, may cause miscarriage. Moreover, this condition can occur not only in women, but also in men.

Hyperprolactinemia in men is also characterized by erectile dysfunction (erectile dysfunction) and prostate disease.

Causes of hyperprolactinemia

If prolactin is elevated, the reasons for this may be different. Hyperprolactinemia can be physiological or pathological. Physiological is normal in pregnant and nursing mothers.

It can be short-term and occur against the background of:

stress;
overwork;
increased physical and emotional stress;
lack of sleep.

In some cases, the reasons for increased prolactin are so minor, for example, fear of medical manipulations, examination by a gynecologist and testing. It is imperative to take this into account if you suspect hyperprolactinemia and carefully prepare for the test, taking it several times.

Hyperprolactinemia can be caused by various diseases, oncopathology, dysfunction of certain organs and systems and infections:

tuberculosis;
hypothyroidism;
cirrhosis of the liver;
polycystic ovary syndrome;
endometriosis;
myoma;
liver or kidney failure;
pituitary tumors.

Pituitary tumors often cause an increase in prolactin in the blood, and adenomas can produce only prolactin or several hormones at once. Therefore, during the examination, it is necessary to examine the area of the “sella turcica”, in which the pituitary gland is located.

Another reason for changes in prolactin levels is the use of certain medications, in particular hormonal drugs, painkillers, antipsychotics, some antiemetics and drugs to reduce blood pressure. You must take this into account and warn your doctor if you are taking them.

Surgeries on the mammary glands, irradiation of the sella turcica can increase the level of prolactin, which time will come back to normal.

Diagnosis of hyperprolactinemia

Elevated levels of prolactin in the blood can be diagnosed during thorough examination a patient who, in addition to general examination An endocrinologist includes the following diagnostic tests:

blood test for prolactin and thyroid hormones;
X-ray of the skull. For the purpose of examining the area of the “sella turcica”;
consultation with an ophthalmologist to identify visual field impairments;
computed tomography or magnetic resonance imaging.

An increased level of prolactin in the blood, in the absence of other data indicating a neoplasm in the pituitary gland, does not serve as evidence of a pathological process and requires repeated research. The patient is warned that it is necessary to prepare for the test.

Since the hormone can increase with physical activity, stress, and it also depends on the day of the menstrual cycle, even within one day you can get different data on the content of prolactin, so blood is taken for analysis in the morning on an empty stomach.

A man can donate blood on any day, but a woman should know that in the second half of the cycle, prolactin levels can be elevated, and it is better to discuss the date of the test with a doctor in advance.

The maximum content of this hormone in the blood is considered to be 500 mIU/l, which corresponds to 25 ng/ml. All data above these values can be considered as a questionable result that requires re-checking.

The study of thyroid hormones is important for determining hyperproteinemia. Often, thyroid diseases affect the secretion of hormones by the pituitary gland through feedback. All these hormones have a similar structure, and feedback regulation is carried out by the same types of receptors.

A high prolactin level of 200 ng/ml indicates a producing pituitary adenoma, which requires compulsory treatment. On an x-ray of the skull it can be detected by a number of signs, one of which is the smoothing of the “sella turcica”. This symptom is observed with large pituitary adenomas. Small ones can only be detected with a tomographic scan.

An examination by an ophthalmologist can detect visual disturbances that occur when a pituitary tumor puts pressure on the pituitary gland. optic nerves. First of all, the patient's complaints are related to loss of visual fields, which can be checked using special ophthalmological tests.

Treatment of hyperprolactinemia

If the level of prolactin in the blood is elevated, this does not always require treatment; in some cases, the patient is examined and observed for some time. Sometimes the level of this hormone is restored on its own if some provoking factors are excluded from the patient’s life. In addition, in some cases, treatment of concomitant endocrine diseases may also reduce prolactin levels in the blood.

Treatment is prescribed when a pituitary adenoma, galactorrhea, menstrual irregularities and infertility are detected.

The main treatment methods are:

drug effects;
surgery;
radiotherapy.

If prolactin is elevated, then how to treat it can only be decided after a thorough examination of the patient.

If a pituitary microadenoma is detected, use medications and prescribe dopamine agonists. The duration of treatment will be approximately a year. During this time, the patient needs to periodically visit a doctor and take tests to determine it. For hyperprolactinemia, it is also prescribed hormonal drugs(glucocorticoids, sex hormones and L-thyroxine).

In cases of menstrual irregularities, it is necessary to keep a schedule basal temperature to get a clear picture of the effectiveness of treatment.

Throughout the entire period drug therapy The level of prolactin in the body is monitored. In addition, a woman needs to constantly measure her basal temperature. Recovery regular menstruation and a normal basal temperature chart themselves indicate that prolactin levels are returning to normal, and, therefore, the woman can become pregnant.

Use in treatment radiation therapy allows you to reduce the size of the tumor. Radiation destroys malignant cells, but, unfortunately, it also has an adverse effect on healthy ones. Currently, high-precision equipment has been developed that allows the beam to be directed as accurately as possible so that the irradiation of adjacent tissues is minimal. The effectiveness of treatment has become much higher, but at the same time it is impossible to completely avoid complications.

Along with the cells that synthesize prolactin, the cells of the pituitary gland responsible for the synthesis of reproductive and thyroid-stimulating hormones. Therefore, many patients who have undergone radiation therapy require replacement treatment and hormonal medications. Under no circumstances should you self-medicate or take any medications without a doctor’s prescription.

If a person experiences an increase in prolactin levels in the blood, they should be constantly monitored by an endocrinologist. You can get specialist advice about hyperprolactinemia at our AltraVita clinic, whose specialists have accumulated great experience in the treatment of this pathology.

Prolactin is a hormone produced by the pituitary gland. It prepares the woman's mammary glands for breastfeeding, 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 cause 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). Most common symptom, occurring in 60 - 90% of cases: menstruation is rare or absent at all. 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. How longer illness, the less galactorrhea becomes (in some patients galactorrhea has been observed for many years). There are three degrees of this disease: third degree - milk separates 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 fat deposits. nutrients in organism.
Problems with the thyroid gland. Since the general hormonal background sex hormones - 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 optic nerves, which leads to vision impairment. Prolactinoma is dangerous because it negatively affects nervous system. Patients have depressive states, sleep disorders.
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 elevated hormone prolactin 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.

Drugs have also found their application plant origin: 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 surgical intervention the relapse rate is 43%.

Some interesting facts about the treatment of hyperprolactinemia

Hyperprolactinemia is the cause of many benign tumors 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.
Surgery 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.

Hormones are very changeable and capricious, but they are extremely necessary for any person, especially a woman. They control almost all body functions. The most important physiological processes, as well as behavior, emotions and feelings depend on work hormonal system. Emerging as a result of work endocrine glands, hormones influence human growth, the development of all organs, reproductive functions, mental condition, sexual attraction. Therefore any hormonal disorders, including increased prolactin in women, it is necessary to diagnose them in time and take measures to eliminate them.

Being one of the most important hormones, prolactin is produced in the brain, namely in the anterior lobe of the pituitary gland, the so-called “sella turcica”. Receptors sensitive to prolactin are found in almost all organs and tissues of the body. But most of all, this hormone has an impact on the reproductive processes and sexual functions of the woman’s body, namely:

stimulates an increase in the number of lobules and ducts of the mammary glands;
promotes the secretion of colostrum and subsequently the formation of milk;
causes the production of the hormone progesterone during pregnancy;
protects the unborn baby from the mother’s immunity;
lowers the sensitivity threshold, reduces painful sensations during childbirth;
regulates the third, or luteal, phase of the menstrual cycle;
helps achieve orgasm during sexual relations;
influences metabolic processes in the body, maintains water-salt balance.

High levels of this hormone in the blood are called hyperprolactinemia. The causes of elevated prolactin in women are divided into two groups: pathological and physiological.

Pathological hyperprolactinemia is caused by organic lesions some organs:

Physiological hyperprolactinemia can also occur in a healthy person. The reasons for the increase in prolactin in a woman in this case are not diseases, but natural states body. High levels of the hormone are observed:

during breastfeeding (lactation);
during pregnancy;
in a state of hypoglycemia caused by fasting;
during and immediately after sexual intercourse;
during sports and heavy lifting physical work associated with lifting weights;
in cases of nipple irritation due to poor-quality underwear or severe physical stress;
as a result of the impact on cervical region spine during long sessions of massage, physiotherapy (in the neck there are nerve nodes that control prolactin levels);
during times of stress, strong fear, caused, among other things, by fear of injections and taking blood from a vein;
when using certain medications, such as estrogens, antidepressants, antipsychotics, amphetamines, opiate drugs.

There are also cases of idiopathic hyperprolactinemia. This diagnosis is made in a situation where the reasons for the increase in prolactin cannot be established.

If a woman has elevated prolactin, then a series arises serious symptoms and consequences:

Diagnosis of elevated prolactin

Hormonal diseases are usually treated by endocrinologists. But since the hormone prolactin is directly related to reproductive function of a woman’s body, it would be better to consult a gynecologist-endocrinologist with this problem. If there is no such specialist in the clinic, then you can make an appointment with a regular gynecologist or endocrinologist. The doctor will write out directions for necessary tests, decipher their results and choose treatment tactics.

First of all, you need to research venous blood on hormone levels. Prolactin is highly sensitive, so you need to carefully prepare for the analysis. It is done in the first phase of the menstrual cycle, in the morning (about 3 hours after waking up) and always on an empty stomach. The day before, a woman should rest well and abstain from sexual intercourse. For more accurate diagnosis the analysis should be repeated two more times . Prolactin levels for a non-pregnant woman:

normal values are 120-500 mIU/l, depending on the phase of the menstrual cycle;
prolactin 1200-1500 mIU/l is not considered critical, but requires dynamic monitoring;
hormone concentrations up to 2000 mIU/l are associated mainly with pituitary tumors.

If elevated prolactin is detected Further examination by specialists is necessary: mammologist, ophthalmologist, neurologist, neurosurgeon and others. To rule out a pituitary tumor, an MRI scan of the brain must be performed. As additional diagnostics An ultrasound of the thyroid gland, mammary glands, and pelvic organs is also performed.

High prolactin levels in pregnant and lactating women

If prolactin is elevated in a woman during pregnancy and breastfeeding, this is the absolute norm. The hormone begins to increase gradually from about 8 weeks of pregnancy, and by the end of pregnancy, prolactin levels can be very high. Upper limits the norm in this case is 10,000 mIU/l. This concentration of the hormone does not require correction and should not frighten the patient. On the contrary, prolactin in such quantities contributes to normal gestation, as well as the development respiratory system and the child’s immunity.

During pregnancy An increase in prolactin is caused by an increase in estrogen. Immediately after childbirth, the level of these hormones begins to decrease and reaches its normal level. With the start of breastfeeding, prolactin increases again, as it begins to perform the function of enlarging the mammary glands and producing milk. Studying the level of the hormone while carrying and feeding a child does not make sense. To accurately diagnose the pathology, it is necessary to wait until the end of pregnancy and lactation.

Treatment of hyperprolactinemia

Treatment of such a disease occurs only after a detailed study of the reasons that caused it and the existing symptoms. If the increase in hormone is caused by a tumor of the pituitary gland, then both drug and surgical treatment are possible.

There is a group of drugs that are, in their pharmacological basis, dopamine agonists or dopaminomimetics. Dopamine is a neurohormone that regulates prolactin in the body. For this reason the doctor can prescribe the following dopamine-containing drugs:

bromocriptine;
cabergoline;
pergolide;
quinagolide;
norprolac;
dostinex.

All of these drugs eliminate the symptoms and consequences of increased prolactin in a woman: milk production stops, the menstrual cycle normalizes, and tumor size decreases.

You need to take medicine long time, because it is persistent therapeutic effect achieved only after two months of treatment. These medications are considered equally effective, but when planning pregnancy, doctors prefer bromocriptine, which has the least toxicity.

If there is no result conservative treatment and the continued growth of the tumor, the patient is prescribed surgery. Modern medical technology make it possible to remove pituitary tumors through the nasal sinuses without injuring the skull.

Hormonal drugs are not prescribed to correct physiological hyperprolactinemia. In this case, normalization of lifestyle, adherence to sleep and rest patterns, and elimination of the effects of stress are usually required.

Contraindications for elevated prolactin

It should be remembered that a high level of the hormone does not mean the presence of a brain tumor or other terrible disease. However, during treatment you must strictly follow all the doctor’s instructions. Self-administration of medications in this case is unacceptable, since this can cause even greater metabolic disorders.

For successful treatment a woman needs comply with the following restrictions:

Diet for hyperprolactinemia

Treatment for such a disease usually does not involve strict diet therapy, but doctors still strongly recommend limiting food consumption With increased content proteins such as beef, pork, chicken, liver, eggs, various cheeses, fish, cottage cheese, red beans and lentils. Don't completely ignore listed product, but their number during treatment should be minimal.

Will help compensate for protein deficiency vitamin complexes containing folic acid, as well as inclusion in the diet Brussels sprouts, broccoli, various varieties of lettuce, spinach, and other vegetables and fruits. For and receiving essential microelements The consumption of nuts and seeds is recommended.

Prevention of increased prolactin and its consequences

There is no specific prevention for increasing prolactin levels. Doctors recommend Do not abuse medications, stay in the sun less. Excessive insolation stimulates the pituitary gland and hypothalamus, which can lead to the formation of prolactin-producing tumors.

When galactorrhea is detected(discharge from the nipple) there is no need to try to squeeze out the contents. Very often, such discharge characterizes the individual sensitivity of breast tissue to normal level prolactin. By constantly pressing on the nipple, you can trigger the mechanism for producing an excessive amount of the hormone.

Regular preventive testing of prolactin concentration in the blood is necessary, even if there are no symptoms of the disease. And with a systematic increase in the hormone, you need to be constantly monitored by an appropriate specialist. Don't panic if your test results are far from normal. Modern medicine has all the necessary methods and means to eliminate high prolactin in women. In most cases, treatment of this disease goes well.