Prolactyna

Proven content

Prolactin is a hormone that has a mammotropic and lactogenic effect and influences the functioning of the gonads. Abnormal levels of this hormone may be related to pituitary adenoma. Its increase may occur under the influence of a large number of stress stimuli or physical exertion. Too high levels of prolactin cause problems with becoming pregnant.

A few words about prolactin …

Prolactin is a hormone secreted by the pituitary gland. Its properties make girls’ breasts grow, and in pregnant women it stimulates the development of mammary glands and the formation of milk (a small amount of prolactin makes it difficult to breastfeed). In addition, in pregnant women, prolactin is responsible for the proper support of the corpus luteum so that it can produce adequate amounts of progesterone – important for the maintenance of pregnancy. Disturbing prolactin levels may indicate the presence of a pituitary adenoma. The increase in its concentration may be a consequence of exercise, stress or hypoglycaemia (lowering blood glucose levels). Hyperprolactinaemia can cause problems with pregnancy (anovulation, failure of the corpus luteum) or a factor that increases the risk of miscarriage. The PRL test is one of the basic research in diagnosing the causes of hormonal amenorrhea.

Note: The concentration of prolactin fluctuates throughout the day: its highest levels are observed in the morning 4: 00-7: 00. Its level may increase after eating a meal containing protein, therefore it is recommended to test this hormone twice: in the morning and in the afternoon.

When do we do a prolactin test?

1. Diagnostics of gynecomastia in men.

2. Diagnosis of hypogonadism in men (decreased libido, impotence, infertility, reduction of sexual hair).

3. Diagnosis of infertility and galactorrhea in women.

4. Suspicion of pituitary adenoma

5. Suspicion of hypopituitarism or hypothalamus.

6. Determining the cause of unusual nipple discharge.

7. Finding the cause of amenorrhea in women.

8. Trouble getting pregnant.

If you’re planning a pregnancy, check your prolactin levels and other parameters important to fertilization. At Medonet Market, purchase the Pregnancy Preparation – blood tests for the expectant mother.

The course of the study of prolactin

Material for the study of prolactin: serum.

Preparation for the examination: fasting (at least 8 hours). Testing for prolactin is usually performed approximately three hours after waking up, between 8:00 am and 10:00 am. In hepatic cases, the so-called circadian rhythm of prolactin is performed – the level of the hormone is checked in the morning and at night. Before the test, do not exercise and avoid stress. Also, 24 hours before the test, nipple stimulation should be avoided as it may raise the level of this hormone.

The course of the study:

– one-time blood sampling from the ulnar vein (a small bruise may appear at the injection site, if the swab is not held long enough after the collection of the skin)

– after stimulation of prolactin secretion by administration of metoclopramide, chlorpromazine or thyreoliberin (nowadays rarely performed),

– after inhibition of prolactin secretion after administration of bromocriptine or levodopa.

Time to wait for the result: 1 Day.

Standards:

a) in women:

– follicular phase – below 23 µg / l,

– lutein phase – below 40 µg / l,

– third trimester of pregnancy – up to 400 µg / l,

What do the individual prolactin norms indicate?

1. 5-25 ng / ml – correct norm,
2. over 25 ng / ml – irregular menstruation and anovulatory cycles,
3. over 50 ng / ml – there is a complete stop of menstruation,
4. above 100 ng / ml – there is a risk of a pituitary tumor.

b) in men – below 20 µg / l.

Valid test values ​​vary from lab to lab.

Comments: Prolactin is the main hormone responsible for the formation and maintenance of lactation. Its excessive secretion leads to menstrual disorders and galactorrhea by influencing the secretion of gonadotrophins and inhibiting sex hormones in the gonads. In men, an increase in prolactin levels leads to decreased libido and infertility. In addition to pituitary adenoma, hypothyroidism and the use of certain medications may also be the cause of hyperprolactinaemia.

Excess prolactin in the body

The causes of excess prolactin:

1. chronic renal failure,
2. stress,
3. intense physical effort,
4. liver disease,
5. Hypothyroidism ,
6. pituitary gland adenoma,
7. taking antidepressants or medications to lower blood pressure.

Too high concentration of prolactin in the body causes various types of ailments. They are mainly associated with the breasts, which become more swollen, painful and sensitive to touch. It happens that high levels of prolactin in a woman who is not pregnant or breastfeeding causes milk discharge from the nipple. Menstrual disorders are characteristic of high prolactin: bleeding may occur more than every 25 days or less than every 33 days. Over time, the bleeding becomes thinner until it stops at all. In addition, the cycles can be ovulatory – which causes problems with getting pregnant. There is a decrease in libido and sexual intercourse is painful due to vaginal dryness.

Where the fault of high prolactin levels is adenoma of the pituitary gland – persistent headaches and visual disturbances are observed. Conversely, when the cause lies in hypothyroidism – weight gain is observed for no reason.

The persistence of the aforementioned ailments for a long time requires consultation with a gynecologist-endocrinologist. Your doctor will probably order a prolactin test first, which you should go to when you are well-rested and on an empty stomach. A high concentration of prolactin will be an indication for thyroid hormone tests. If they do not show hypothyroidism – it will be necessary to repeat the prolactin test. Confirmation of the presence of a tumor is an indication for computed tomography or magnetic resonance imaging to determine the location and size of the tumor.

Treatment of excess prolactin

There is no one specific method for reducing high prolactin levels. If the high level of this hormone is due to the medications taken, the doctor recommends discontinuing them or replacing them with other medications. In people with diseases of the thyroid, liver or kidneys, treatment is focused on curing the underlying disease, thanks to which the level of prolactin is reduced.

The matter becomes more complicated in the case of pituitary adenoma. It is not known why, the tumor is formed from glandular tissue and therefore has the ability to secrete hormones. The bigger this tumor is, the more hormones it can release. Most tumors are benign tumors. If they are small, it is enough to administer special preparations, such as Dostinex, Bromocriptine or Norprolac, for the tumor to disappear or shrink after several months of treatment. In the case of tumors that do not respond to treatment or are too large – surgical intervention is required. The neurosurgeon makes a small incision under the upper lip inside the mouth to enter the pituitary gland and remove the tumor. In some cases, radiation therapy is also necessary.

important: despite recovery, the level of prolactin in the body should be monitored for the rest of your life.

What other hormones does the pituitary gland release?

The size of the pituitary gland resembles a bean attached to the base of the brain with a peduncle. The front, larger lobe of the pituitary gland secretes hormones responsible for the production of other important hormones:

1. TSH (thyroid stimulating hormone) – responsible for the release and production of thyroid hormones – T3 and T4;
2. ACTH (adrenocorticotropic hormone) – responsible for regulating the function of the adrenal glands and the secretion of cortisol;
3. GH (growth hormone) – responsible for the development of muscles, bones and cartilage;
4. FSH, LH – other gonadotropic hormones, next to prolactin, which are responsible for the stimulation of the ovaries in women and testicles in men.

The tyre’s pituitary gland directly affects certain cells in the body. So they are not overriding other hormones:

1. ADH, vasopressin – by affecting the kidneys, it prevents dehydration of the body;
2. oxytocin – stimulates labor contractions of the uterus and stimulates the leakage of milk from the breast in a nursing woman.

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