Prolactin is increased: the causes, symptoms, treatment, consequences

If the hormone prolactin is increased, the menstrual cycle and the hormonal background are broken, as well as infertility or problems with bearing a child. Therefore, women need to determine at their blood level when planning pregnancy.

Prolactin is produced by the pituitary gland - the endocrine gland located in the brain. This process is controlled by the hypothalamus. The level of the hormone is very sensitive to external factors. So, high prolactin can be for the following reasons:

• medications;

• Kidney failure;

• stress;

• cirrhosis of the liver;

• sleep;

• Cushing's syndrome;

• Addison's disease ;

• acromegaly;

• Sarcoidosis;

• Neurotuberculosis;

• Tumors;

• Postpartum period;

• pregnancy;

• Stimulation of the nipples;

• lactation;

• Sexual intercourse;

• anesthesia;

• Lesions and surgical interventions on the chest.

On different days of the cycle, the level of the hormone in the blood varies from 6 to 28 ng / ml. To obtain reliable results, you can not take an analysis after sleep or procedures. Prolactin secretion occurs impulsively, and the frequency depends on the phase of the cycle. There are also daily fluctuations in its level, for example, after awakening, the concentration of the hormone is the smallest. After falling asleep, his secretion increases and grows in a dream.

In a third of patients who have prolactin increased, an adenoma of the pituitary gland is found. If its size is large, then the hormone level is more than 100 ng / ml. Smaller indicators can be with microadenomas of small sizes, not detectable by X-rays.

The most informative method for diagnosis of pituitary neoplasms is MRI. It must be done when planning a baby, if there is a suspicion of the presence of adenoma, since a large lesion can contribute to the occurrence of complications.

The dimensions of the pituitary microadenum do not exceed 1 cm. They grow very slowly and, as a rule, are benign. The diameter of the macroid is more than 1 cm. They are accompanied by headaches, changes in the visual fields, and sometimes its complete loss. When a macroadenoma is found, the consultation of the neurosurgeon is necessary. He decides about the surgery. During pregnancy, microadenomas usually do not change, but large growths in 20% of cases grow.

Also, prolactin is often increased in renal failure (chronic). With kidney transplantation, its secretion is normalized.

If prolactin is elevated, then the goals for treatment are as follows:

• Reduce its level;

• Restore the cycle;

• Reduce the size of the tumor if it is present.

One of the drugs used to reduce the hormone is bromocriptine, which is a dopamine agonist. It suppresses the secretion of prolactin, stimulating receptors in the brain. Doses of the drug depend on the severity and nature of the disease. After starting the application of bromocriptine, the cycle is restored on average after 7 weeks. Although in some patients this happens in a few days.

Normally, bromocriptine is taken several times a day. If necessary, the dose may be increased. Treatment should continue several cycles after the recovery of menstruation to prevent relapse. Side effects of bromocriptine:

• Fatigue;

• dizziness;

• headache;

• Vomiting;

• Dry mouth;

• nausea.

To increase prolactin may lead to hypothyroidism. The reception of homons in this case leads to a normalization of its level.

Indications for the purpose of analysis for prolactin are as follows:

• osteoporosis;

• Gynecomastia;

• Decreased potency and libido;

• Hirsutism;

• obesity;

• Severe menopause;

• Disorders of lactation;

• infertility;

• Anovulation;

• Mastopathy;

• Discharge from the nipples;

• Amenorrhea, oligomenorrhea;

• Cyclic pain in the chest.

Thus, prolactin is elevated in most cases because of the pituitary adenoma. In addition, the common cause of its high concentration is hypothyroidism. Increased concentration of prolactin leads to a violation of menstrual function and the absence of ovulation, so the conception and bearing of a child becomes almost impossible. Treatment is to reduce its level, eliminate the cause of the disease and restore the cycle.