Prolactin (lactogenic hormone, lactotropic hormone, mammotropic hormone) is one of the hormones of the anterior pituitary gland. Estrogens and dopamine directly affect its normal production.
Its meaning for a woman, one way or another, is connected with reproductive function, the ability to conceive and bear children. It is very important to know what this hormone is responsible for, the norm of prolactin, to monitor its indicators in the blood in order to identify the pathology in time.
Prolactin functions
So what is prolactin responsible for? Most of the functions of this hormone are related to reproduction:
- appearance of secondary sexual characteristics in girls;
- in the last trimester of pregnancy is involved in the growth of the mammary glands and the increase in the ducts in them;
- starts production of colostrum after childbirth, which is converted into milk, filling the mammary glands between feedings;
- during lactation blocks the onset of ovulation and subsequent conception;
- the higher the level of prolactin, the lower the pain threshold in women inthe birth period, because prolactin has an analgesic effect;
- regulates the menstrual cycle;
- in men, prolactin is involved in the formation and maturation of spermatozoa, is responsible for sexual he alth;
- takes part in the immune response to inflammation.
As you can see from the functions, the production and the right amount of hormone content in the blood is important not only for overall he alth, but also for the birth and feeding of children.
There are 3 types of causes of increased prolactin:
- Physiological.
- Pharmacological - these are the consequences of taking certain drugs.
- Pathological is a violation in the endocrine system of the body.
Physiological increase in blood prolactin
Elevated prolactin is not yet a pathology. Absolutely ordinary physiological factors can also influence its quantitative changes. Under the influence of another hormone - estrogen - prolactin rises during pregnancy, and with each trimester its level increases. The increase in estrogen directly affects the increase in prolactin. For a pregnant woman, this is necessary in order to feed the child later. During pregnancy, despite the fact that prolactin rises, the lactation process cannot yet be started, because the blood also contains a large amount of progesterone, the decrease of which will begin after the placenta is released during the birth period. It is normal for prolactin levels to be high during breastfeeding as well.
Also increase this pituitary hormoneobserved during menstruation, exercise, sexual intercourse, during stress and pain, hunger.
During the day there are differences in the content of prolactin in the blood, for example, after waking up it is much higher than after 3 hours of wakefulness.
Pathological and pharmacological causes and consequences of elevated prolactin in women
- Tumor in the pituitary gland.
- Hepatitis and cirrhosis.
- Autoimmune diseases.
- Diabetes mellitus.
- Polycystic ovaries
- Renal and liver failure.
- Hypothyroidism.
- Acromegaly.
- Anorexia.
- Uterine fibroids.
- Endometriosis.
- Alcoholism and drug addiction.
There are medications that can increase prolactin levels as one of the side effects. These are contraceptives with a high proportion of estrogen, antiemetics, antipsychotics, Reserpine, Verapamil.
One of the serious negative consequences of elevated prolactin is infertility. Violation of menstruation, irregular ovulation or its absence lead to the impossibility of conception. This cause is identified in a quarter of women who are unsuccessfully trying to conceive.
The consequences of hyperprolactinemia can be different. The disease sometimes affects the work of the central nervous system. It can be serious depressive disorders, insomnia. The fairer sex sometimes feel a decrease in sexual desire.
Cases in which it is necessary to take a blood test for prolactin
When to donate prolactin? Reasons for verification will be as follows:
- Female and male infertility. Primary or secondary.
- Irregular menstruation, amenorrhea - absence of menstruation for more than six months.
- Uterine bleeding.
- Discharge from the mammary glands - galactorrhea, often combined with mastopathy.
- Thyroid disease.
- Irreducibly overweight.
- Excessive growth of facial hair.
- Frequent headaches, mood swings, depression.
- Lack of lubrication in the vagina.
- Severe menopause.
- Signs of osteoporosis due to leaching of calcium from the blood.
- Male erectile dysfunction.
- Breast enlargement in men.
Table of Prolactin norms
Its amount is influenced by the presence of pregnancy, the day of the menstrual cycle (the closer to ovulation, the higher the concentration of the hormone). What should be the norm of prolactin in the blood? In different periods of a woman's life her own. External stimuli, excessive physical activity, strong emotions, food intake and certain medications also affect the amount of the hormone. The highest production occurs from 1 am to 5 am.
The table shows the norms of prolactin by age and different periods of a woman's life.
| Period | Norm, ng/ml |
| Pregnancy (from 8 weeks) and lactation | 35-385 |
| Women of childbearing age | 4-22, 8 |
| Girls and women after menopause | 19-20 |
The Importance of Prolactin for Men
In men, increased prolactin affects the decrease in testosterone synthesis, which reduces potency, libido and leads to infertility. Breast glands can grow and even milk can be secreted. The norm of prolactin in men is 3-15 ng / ml.
What does a decrease in prolactin indicate
The level of lactotropic hormone may be below normal. This occurs with a disease such as Sheehan's syndrome, caused by pituitary insufficiency. If a woman prolongs her pregnancy, then prolactin will also be lowered in her blood.
How to get tested for prolactin
Blood for analysis is taken from a vein, 2-3 hours after sleep, regardless of the day of the cycle (the result will be compared with the day of the cycle).
Preparatory measures are to refrain from sexual contact, physical exertion, excessive exposure to heat or cold 3 days before delivery. Limit the intake of coffee, sweets, eliminate overeating. You can not take a hot bath, go to the bath.
When is prolactin taken again? As described above, the quantitative content of the hormone may vary depending on many external and internal factors. If, after a laboratory test, an increase in the norm of prolactin in the blood is detected, it should be taken again for at least 3 more menstrual cycles.
Additionally, after the doctor decrypts the analysis data, it may be necessary to confirmexamination of the thyroid gland, ultrasound of the gastrointestinal tract, mammary glands, determination of blood sugar levels. If a patient has a visual impairment, they are referred to an ophthalmologist.
With significant levels of prolactin, computed or magnetic resonance imaging is prescribed to detect or exclude the presence of a tumor. Small pituitary adenoma found in 15% of the population and does not affect he alth.
Treatment of hyperprolactinemia
Self-treatment should never be carried out, the dose is selected by an endocrinologist. The main method of treatment is medication. Usually this process is quite long, it will not be possible to quickly reduce the level of the hormone, the approximate period varies up to six months. If the goal of treatment is pregnancy, therapy will continue for about a year.
Therapy focuses on:
- reducing the hormone to normal;
- restoration of menstruation and ovulation;
- normalize fertility;
- tumor reduction.
The main drugs include 3 generations:
- "Bromocriptine", "Parodel" (derivatives of ergot alkaloids).
- Norprolac (Quinagolide).
- Dostinex (Cabergoline).
These drugs belong to the group of dopamine receptor agonists (dopaminomimetics), they have different selective effects on prolactin receptors, and therefore different in duration of action and tolerability. Their doses are selected individually by the doctor, starting treatment with minimal dosages. Onceper month, under the control of a blood test, the dose is gradually increased, bringing the level of prolactin to normal.
Often, when taking Bromocriptine, side effects such as nausea (it is better not to take it on an empty stomach), drowsiness, low blood pressure, dizziness are noted. But since its toxic effect is more studied, when prescribed during pregnancy, it will be the drug of choice. Side effects of Dostinex and Norprolac are less pronounced. Against the background of treatment, the hormonal background normalizes, the ability to conceive is restored, the size of the tumor decreases, and the symptoms of elevated prolactin are eliminated.
If drug treatment does not reduce the neoplasm, even the maximum doses and changing the drug do not help, the patient may be prescribed more radical methods - surgery or radiation.
Surgical intervention occurs with minimal risks and injuries, since the tumor is removed through the sinuses with an endoscope. It is indicated for the ineffectiveness or intolerance of drugs, severe visual impairment, the growth of a neoplasm in a pregnant woman.
Additional recommendations
You can add soothing medicinal herbs to the treatment with drugs, such as mint, lemon balm, valerian, hop cones. It is important to observe the sleep and rest regimen, try to eat right, lose weight, play sports, eliminate bad habits. Stop taking drugs that provoke an increase in prolactin.
Foods that will help bring the homon back to normal faster should contain a lot of protein,vitamin B6, folic acid, tyrosine and folate. Eat more legumes, greens, fresh vegetables and fruits, whole grain breads, lean meats, he althy fish and seafood, as well as eggs, seeds, flax seeds, nuts.
It is important not only to include he althy foods in the diet, but also to exclude foods that increase the amount of prolactin, this is not whole grain bread with yeast, sweets, sausages, smoked foods.
Pregnancy and prolactin
The described causes and consequences of increased prolactin in women deprive her of the possibility of a natural pregnancy. After many unsuccessful attempts, the reason often lies precisely in a hormonal disorder. As a result, a woman gets acquainted with such a diagnosis as hyperprolactinemia. Yes, lowering the hormone level is not easy, but after normalization, the long-awaited two stripes will appear on the test.
After the onset of pregnancy, therapy is interrupted and the level of prolactin is no longer measured, the indicators will be high anyway. This hormone is also needed by the fetus for the development of lung tissues.
During breastfeeding, this hormone also reaches high levels, not for nothing that its name comes from the Latin lactis - milk, for which prolactin is responsible. By the way, it is because of him that some children are born with swollen mammary glands, since the hormone enters the body in utero, everything will return to normal soon.
At the end of the article
This article shows that prolactin is invaluable to ourorganism. A timely appeal to a gynecologist and endocrinologist, following their recommendations will help the long-awaited pregnancy, restore he alth and quality of life.
