The hormone prolactin and its deviations from the norm in women. What should be the prolactin level in women Prolactin norm in women by cycle phases

What is prolactin responsible for?

1. Helps normalize adrenal activity through the production of androgens.
2. Regulates the size of the mammary glands in women during puberty. At the end of the process, it is prolactin that prepares the mammary glands for lactation. It also regulates milk production during feeding.
3. It is a natural contraceptive: due to its special properties, a woman cannot conceive a child during her current pregnancy or lactation.
4. Causes the development of maternal instinct and corresponding behavioral reactions when it is normal in women.
5. Controls the presence of the corpus luteum in the ovaries. Few people know that prolactin in women helps maintain a normal amount of progesterone, which helps in the successful bearing of a child.

In the male body, prolactin is responsible for the regulation of spermatogenesis, sexual function, and the production of prostate secretions. To a greater extent, prolactin in the body of any person is responsible for sexual function and the reproductive system.

What is the normal prolactin level in women?

Once the analysis is done, the results can be presented in different quantities, including µIU/ml. In this case, you will need to convert them to ng/ml, based on the ratio: 1 ng/ml=30.3 µIU/ml.

Separately, you can consider the table, which shows the norm of the hormone prolactin in women in honey/l:

When answering the question, what is the normal level of prolactin in the blood of women, you can give as an answer a table with a classification of indicators by age:

It should be borne in mind that in any of these periods the indicators may vary slightly and deviate from the specified norm in one direction or another. This is a natural process that is influenced by external factors and individual characteristics of a person. In addition, the result may deviate slightly from the norm if the patient neglected the rules for preparing for the analysis.

The normal level of prolactin in women increases after taking the following medications: antiemetics, reserpine, antidepressants, hallucinogens, amphetamines, opiate drugs, estrogens, etc.

The level of prolactin in the blood of women can be determined using a special test, which is recommended to be taken from girls during puberty and from women who have problems conceiving a child. In addition, this test is also required for men in case of problems with the reproductive system. To detect the hormone, simply donate blood from a vein.

Specialists such as a gynecologist, endocrinologist, therapist or andrologist can give a referral for analysis.

• On the day of delivery, you need to be in a calm emotional state, not be nervous and try not to experience increased excitement. This may affect the result.
• Try to limit physical activity during the period of blood donation. Moreover, in this case, even running up flights of stairs can play a role. If you cannot avoid the load, then be sure to rest for at least 15-20 minutes before the analysis.
• Try to abstain from sexual intercourse the day before the test. Prolactin results may otherwise differ from actual results by 2-3 times.
• You need to wake up at least 3 hours before the test.
• Smoking is allowed, but only 1-2 hours before the test.
• At least 8 hours must pass from the last meal to the time of testing. In addition, for the analysis to show normal prolactin levels in women, dinner should consist of light foods. The ideal option would be a vegetable stew or a light salad without meat. You should also not drink strong drinks, including tea and coffee. It is best to use clean water.
• Be gentle with the delicate skin in the areola area. Even tight or uncomfortable underwear can stimulate hormone production.
• You need to get a very good night's sleep. Lack of sleep also has a powerful effect on hormone levels. To find out the most accurate amount of prolactin in the blood of women, you should sleep at least 7 hours.

Symptoms when prolactin is not normal

• Irregular menstrual cycle;
• Constant stress, depression and depression;
• Decreased sexual desire;
• Change in body weight;
• Frequent headaches and migraines;
• Problems during puberty: excessive hair growth, dermatological problems, etc.
• Enlargement of the mammary glands;
• The occurrence of caries in several places simultaneously;
• Infertility;
• Colostrum release;
• Sudden deterioration of vision.

What does it mean when prolactin is higher/lower than normal in women?

• Diseases and pathologies of the adrenal glands;
• Diseases of the hypothalamus, for example, tuberculosis, metastases, etc.
• Pituitary tumor;
• Polycystic ovary syndrome;
• Cirrhosis of the liver;
• Kidney failure;
• Diseases of the pituitary gland, for example, mixed adenoma, brain cyst, etc.
• Reduced thyroid function.

If it is found that prolactin is below normal in women, this may be due to various problems with the ovaries, conception and the reproductive system in general. In addition, the process of puberty may be slowed down, so there is no need to put off going to the doctor.

Prolactin levels during pregnancy and breastfeeding (video)

Update: October 2018

Prolactin (PRL) is a hormone synthesized by the pituitary gland in extremely small quantities. But even such a small level has a colossal effect on the entire body. It is important to know the norm of prolactin in the blood of women, since the reasons for deviation from it can be very serious.

Norm prolactin

It is noted that the amount of this hormone does not always reflect the strength of clinical manifestations. For example, women with severe hyperprolactinemia may have regular menstruation, good ability to conceive and bear a child, and a slight excess of the norm may be combined with serious and unpleasant symptoms.

This phenomenon is associated with the existence of 4 different forms of the hormone:

• "small" BPD
• "big" BPD
• macro-PRL
• glycosylated PRL

All of these forms have different effects on target organs, so their identification is extremely important. Microprolactin is considered the most active; it is the one that causes all external manifestations of hormonal imbalance. Large forms of this substance are bound and therefore almost inactive.

Outside of pregnancy, a woman’s normal level of the hormone prolactin does not exceed 20 ng/ml (600 µU/ml). A rise in level to 1000 µU/ml is considered mild and insignificant. If hyperprolactinemia is detected, a macroprolactin test is additionally prescribed. If its amount exceeds 60%, then bioactive PRL is only 40%, which may well be within the normal range. If macroprolactin is low (less than 40%), then the active hormone is still outside the normal range and requires further examination.

Prolactin during pregnancy

As the day of birth approaches, the amount of estrogen in the blood of the expectant mother increases. This, in turn, stimulates the synthesis of PRL, the level of which increases several times, which is the absolute norm. Therefore, for pregnant women, this test is not informative and is not taken.

Nature has created such a mechanism so that by the time a child is born, a woman’s mammary glands are ready to secrete milk. PRL increases to its maximum at 25 weeks and decreases slightly before birth. With the first breastfeeding, prolactin levels increase in response to nipple stimulation.

Hormone functions

Prolactin has many different effects on the female body. This is not surprising, because there are receptors for it in the mammary glands, ovaries, uterus, placenta, liver, eyes, lymphatic and immune cells, brain, kidneys, adrenal glands, intestines and pancreas.

Effects of BPD:

• Prepares the mammary glands for lactation
• Stimulates milk synthesis after childbirth
• In the second phase of the cycle, it supports the functioning of the corpus luteum, which produces progesterone.
• Takes part in the ovulation process
• Regulates the composition and volume of amniotic fluid
• Has immune properties

Symptoms of hyperprolactinemia

• a (rare or absent menstruation)
• (due to lack of ovulation or shortening of the 2nd phase of the cycle)
• Galactorrhea (leakage of milk from the breast) – occurs in 70% of cases
• Headache, loss of vision (with large pituitary tumors)
• Decreased libido
• , (in 20% of patients)
• Obesity (in 40-60% of cases)
• Depression, insomnia (in 20% of cases of hyperprolactinemia)
• Memory loss
  

Reasons for increased prolactin levels

Physiological reasons

The amount of hormone in each individual woman varies throughout the day. It is known that during sleep the level of PRL increases, starting from 60-90 minutes. This occurs both during night rest and during daytime sleep, and after waking up the amount of the hormone drops sharply. A slight rise is also observed during physical activity, sexual intercourse, and also after eating protein foods. Stress reactions can also affect the hormone, especially when combined with physical stress (for example, fainting during a blood draw is a guarantee of an increase in PRL).

Pituitary gland diseases

Prolactinoma, a common tumor of the pituitary gland, is the most common cause of high levels of PRL in the blood. Depending on its size, it is called microprolactinoma (less than 1 cm) or macroprolactinoma (more than 1 cm). About a quarter of the world's population has undiagnosed pituitary microtumors, which do not cause significant symptoms and may simply be an incidental finding.

Most often, such adenoma is diagnosed in women aged 30-40 years. The female sex is characterized by the small size of the neoplasm. In addition to impairing reproductive function, the tumor can compress the visual pathways, leading to loss of vision, as well as cause headaches and impair quality of life. Therefore, with a proven adenoma (prolactin is higher than normal due to the microfraction, MRI shows a tumor), treatment with Dostinex or surgical removal is necessary (extremely rare). When planning a pregnancy, you need to take Dostinex for a year, then if you successfully try to conceive, stop the drug.

Other pituitary tumors

Any neoplasm that blocks the pathways between the pituitary gland and the hypothalamus can cause an increase in the concentration of PRL in the blood. Sometimes they are all combined under the term “pseudoprolactinoma,” although along with prolactin the amount of other hormones (GH, ACTH) also increases. Most of them have their own features on MRI and CT, but the number of PRL is much lower than in the case of true prolactinoma.

Primary hypothyroidism

The connection between decreased thyroid function and increased PRL in the blood has not yet been precisely explained. But almost half of patients with hypothyroidism have similar changes in tests. After starting replacement therapy, prolactin also returns to normal. We must not forget that hypothyroidism can easily coexist with brain tumors and other pathologies.

Polycystic ovary syndrome

The classic case of PCOS includes menstrual irregularities, ovarian cysts, and elevated androgen levels. But in 30-40% of cases, hyperprolactinemia is added to these signs. The reasons for this relationship are not precisely known. But for any suspicion of PCOS, it is necessary to take a test for prolactin and macroprolactin in order to prescribe the necessary treatment (see).

Chest injuries

It is known that various surgical interventions can increase the PRL indicator for a period from a day (for abdominal surgery) to several months (for manipulations in the chest area). The same effect occurs with herpes zoster (Herpes zoster virus), which affects the skin of the upper body. This is due to increased nerve impulses from the damaged area to the brain. The closer the source of irritation is to the mammary glands, the more intense and durable these impulses are.

Idiopathic hyperprolactinemia

It happens that a moderate increase in the amount of the hormone in the blood (25-80 ng/ml) exists independently, without visible pathology of the hypothalamus and pituitary gland. Such cases are called idiopathic (causeless). Most people with this form of the syndrome have macroprolactinemia without needing treatment.

Hypothalamic diseases

The hypothalamus is one of the highest links in the endocrine system. Therefore, any disruption of its function leads to changes in the level of all hormones, including PRL. Hyperprolactinemia may result from a hypothalamic tumor, craniopharyngioma, glioma, inflammation in the brain, metastatic disease, and abnormal vascular development. A similar effect occurs with therapeutic irradiation of the brain.

Estrogen-producing tumors

Many neoplasms are capable of secreting hormones. In women, ovarian tumors often synthesize estrogen in large quantities. This leads to a natural increase in prolactin. Therefore, such changes in tests are a reason to examine the pelvic area with an ultrasound.

Taking medications

Sometimes prolactin in women is increased when taking certain medications: antipsychotics (haloperidol, aminazine), antiemetics (cerucal, moltilium), reserpine, levodopa, opiate substances (morphine), verapamil, etc.

Reasons for decreased prolactin levels

• Pituitary infarction after childbirth
• Taking medications

Pituitary infarction (Sheehan syndrome)

During pregnancy, a woman's pituitary gland increases in size, but its blood supply does not improve. Therefore, massive blood loss or a drop in pressure during labor can lead to a heart attack of this important organ. As a result, pituitary cells die and there is a deficiency of hormones, including prolactin. In such patients, prolactin levels in tests are low, so breastfeeding is impossible. If the volume of the pituitary gland that has undergone necrosis is too large, then the woman will need replacement therapy.

Taking medications

Some medications and substances can reduce hormone secretion: dopamine, pyridoxine, diuretics, nicotine. The latter explains problems with breastfeeding when smoking, when prolactin is below normal.

When is a prolactin test needed?

How to take the test correctly?

The hormone level is quite sensitive to all external influences, including stress, physical and nutritional stress. Therefore, to exclude physiological hyperprolactinemia, you need to be tested three times. Blood collection is carried out in the morning on an empty stomach.

The day before the analysis, you need to exclude sexual intercourse, exposure to heat (in a sauna, bathhouse), and intense training. Immediately before the procedure, it is better to sit in a chair, relax and calm down.

Additional examination

If a blood test shows three times that the amount of PRL is not normal, then additional tests are usually performed:

• History of medication use
• Job evaluation)
• CT, MRI of the pituitary gland and hypothalamus
• Ultrasound of the pelvic organs
• Assessment of liver and kidney function (biochemical blood test, ultrasound)
• Hormonal profile (FSH, androgens, estradiol)

Any changes in a woman’s hormonal profile are indications for further examination. If there are deviations only in the numbers on the form, and there are no symptoms at all, then treatment is most likely not required.

Among the hormones in the human body, prolactin occupies a special place. This biologically active substance, produced by the anterior lobe of the pituitary gland, consists of almost two hundred amino acids. The structure of prolactin is similar to the structure of the growth hormone somatotropin, but its functions are somewhat different. All of them are directly or indirectly related to the birth of offspring.

Thanks to prolactin, mammary glands form in girls during adolescence, and milk is produced in women in labor. A small part of the hormone is synthesized in the endometrium - the inner mucous membrane of the uterine body, which lines its cavity. Prolactin levels are closely related to the course of the menstrual cycle.

Prolactin is also present in the body of men, but in much smaller quantities. You don’t need a lot of it, since an excess of this hormone can cause infertility.

Prolactin has a characteristic daily rhythm of secretion. Its maximum level is observed in the morning. Throughout the day, the concentration of the hormone decreases and becomes lowest in the evening.

The normal level of prolactin in the blood varies depending on the following signs:

• person's age;
• gender: female or male;
• presence of pregnancy;
• individual characteristics.

Prolactin test

Carrying out a blood test to determine prolactin levels prescribed to women if they have the following symptoms:

• Absence of menstruation for six months or more.
• Impaired fertilization function - pregnancy does not occur, although sexual activity is regular and partners do without contraception.
• The appearance of milk in the female breast, but there is no pregnancy or lactation.
• Regular headaches and vision problems.

Male representatives It is recommended to take the same analysis in the following cases:

• Enlarged mammary glands – gynecomastia (not associated with weightlifting or bodybuilding).
• Erection problems.
• The appearance of migraines and sudden deterioration of vision.

Blood for the study is taken from a vein. The method used in the laboratory diagnostic process is called chemiluminescence immunoassay (CHLA).

Preparing for a prolactin test

Women should get tested in the first three days of their menstrual cycle.

In order for the results of the study to be as objective as possible, at least one day before diagnosis it is necessary:

• Refrain from sexual intercourse.
• Do not take hot baths or go to the sauna.
• Postpone active sports and avoid other physical stress.
• Avoid stressful situations, since prolactin levels are significantly affected by a person’s emotional state.
• Do not smoke or drink alcohol.
• Avoid exposure to the mammary glands (examinations, palpation, massages).

The analysis takes place in the morning, but not immediately after the person wakes up, but three to four hours later. There is no need to have breakfast, since blood is donated on an empty stomach. Before the procedure, it will not hurt to calm down and rest for a few minutes by sitting in the waiting room.

Video recipe for the occasion:

More often, the test result shows an excess of the normal level of the hormone. This is problem-free for women during lactation or pregnancy. Under other conditions, in representatives of both sexes, an excess of prolactin norm signals about pathologies that have arisen in the body.

The hormone is very sensitive and reacts even to minor changes in physiology caused by sexual desire, medication, and stress. Therefore, the analysis should be repeated and at least two laboratory diagnostics should be performed.

Prolactin: normal for women

The role of the hormone prolactin in a woman’s body is invaluable. He is responsible for the normal passage of such processes:

• Formation of mammary glands and their development.
• Supporting the existence of the corpus luteum during pregnancy.
• Establishing the production of progesterone, the hormone responsible for pregnancy.
• The formation of colostrum after the baby is born and its conversion into breast milk.
• Lactation support.

Therefore, it is so important not to allow the hormone levels to deviate from the norm.

Prolactin is also a kind of contraceptive. To a small extent, it prevents possible conception during the period of feeding the baby with breast milk. After a woman has weaned her baby, the likelihood of becoming pregnant increases.

• nanogram per milliliter (ng/ml);
• micro international unit per ml (µIU/ml).

For women who are not in an interesting position, the prolactin norm is set in a significant range: 4.4–48.0 ng/ml (133.3–1454.4 μIU/ml). It is valid from the time of the first menstruation until the onset of menopause.

The value of the norm depends on the menstrual cycle. In accordance with its phases, the optimal prolactin content is:

During pregnancy, the hormone levels change. It is normal to increase from the middle of the first trimester of pregnancy. During this period, increased synthesis of estrogen occurs, which causes an increase in prolactin levels to 44 ng/ml.

From the middle of the second trimester to its end, the maximum increase in hormone levels occurs. It is during this period that the lung tissue of the embryo is formed. The normal prolactin level is in the range of 14.0–167.0 ng/ml.

Closer to the birth of the baby, the hormone content decreases to 118 ng/ml. When the baby begins to breastfeed, the amount of prolactin increases again.

With the onset of menopause, a woman's body undergoes changes. Prolactin levels begin to decrease. The hormone level several months after the complete cessation of menstruation is in the range of 2.5–40.0 ng/ml. Over the years, it gradually decreases further.

Prolactin in men: normal

For representatives of the stronger sex, it is important to maintain normal levels of prolactin, since it significantly affects the effectiveness of the fertilization process. In men, this hormone performs the following functions:

• Keeps water-salt metabolism under control, that is, the vital processes of consumption, absorption and distribution of water and salts within the body, and their release to the outside.
• Enhances the effect of testosterone.
• Stimulates sperm development and motility.

The level of the hormone in representatives of the stronger sex is lower compared to that for women. If a man is absolutely healthy, then the concentration of prolactin varies as follows: 2.5–17.2 ng/ml (75.8–521.2 μIU/ml).

Symptoms of excess hormone levels are as follows:

• A sharp decrease in sexual desire.
• Constant problems with erection.
• The appearance of a rash on all parts of the body.

Excessive prolactin muffles and inhibits the action of hormones, with the help of which feelings of joy and pleasure are formed, and the desire to repeat the pleasure received. This applies to dopamine, which is also responsible for sexual arousal. Prolactin level is an indicator of sexual saturation and relaxation.

Exceeding the normative level of the hormone is dangerous because a man can become infertile.

If six months of attempts to conceive a child have led nowhere, you should definitely do a blood test to check the content of prolactin. When the result indicates that the hormone content is above the norm, the specialist prescribes additional tests and adequate treatment, and introduces the recommendations. As a result of following the doctor's instructions, the problem is successfully resolved in most cases.

Norm prolactin in children

In one-month-old babies, prolactin levels are high. Its values ​​can reach 49.5 ng/ml (1500 µIU/ml). This situation is explained by the fact that maternal hormone enters the child’s body. Often the baby’s mammary glands swell and colostrum is released from the papillae.

Gradually, the content of prolactin in the child’s blood decreases and in the first twelve months of life is:

In children under seven years of age, the hormone level should not exceed 10 ng/ml (303 µIU/ml). Then it starts to rise.

The optimal prolactin level in girls and boys from ten to thirteen years of age is in the range of 3.6–12.0 ng/ml (109.0–363.6 μIU/ml).

In adolescents, hormone levels gradually approach those of adults. And it is higher for girls than for boys.

Exceeding the norm of prolactin in the blood reflects a violation of sexual functions in the female and male bodies. This is fraught with serious problems with conception and possible infertility.

The results of the prolactin test only indicate its deviation from the norm. The cause of this condition must be sought through additional research.

Prolactin is a hormone that is designed to stimulate the production of breast milk and is also necessary for the growth of the mammary glands. A blood test for prolactin can help determine the reasons for the release of breast milk in nulliparous women, infertility, etc.

Prolactin is produced in the cells of the pituitary gland (located in the brain), so an increase in its level (except in cases of pregnancy or some time after childbirth) may mean the presence of pathologies in the body such as hypothyroidism, pituitary tumor, etc. To reduce prolactin levels, medications can be used therapy, as well as surgery. The treatment method is chosen exclusively by the attending physician and directly depends on the cause of the increase in prolactin.

Main functions of the hormone

Prolactin is a protein that is produced by the pituitary gland, as well as the lining of the uterus.

Prolactin is the most important component in the work of the female body during pregnancy, during puberty, after childbirth, and its main functions are:

• growth of mammary glands and their development in girls during adolescence;
• increase in breast size during pregnancy;
• is the initiator of the formation of breast milk.

It is worth noting that the stronger sex also produces prolactin, but in our time the effect of this hormone on the male body has not been fully studied.

Indications for blood tests for prolactin

An increase in prolactin levels can be caused by serious pathologies, so a blood test for this hormone in women should be performed in the following cases:

• amenorrhea (cessation of menstruation for a period of several months to six months or more);
• galactorrhea (the appearance of breast milk not during pregnancy or after childbirth);
• visual impairment (for unknown reasons);
• infertility;
• regular headaches (without visible pathologies).

Preparation for analysis

To determine the level of prolactin in the body, a blood test is necessary. This procedure is performed on an empty stomach, and blood is drawn from a vein. To ensure that the results of the blood test are as accurate as possible, it is strongly recommended that you refrain from sexual intercourse the day before the procedure. In addition, prolactin levels may be increased if there is recent nipple irritation. It is known that the level of the hormone prolactin can change repeatedly during the day, therefore, in order to avoid receiving unreliable results, you should wake up 3-3.5 hours before the test, and the best time to donate blood will be in the morning (from 8 to 10 hours).

Another factor that influences changes in hormone levels in the body and, accordingly, the accuracy of test results is stress. You should try to avoid unpleasant situations and also be in a good mood. You need to know that donating blood to determine the level of prolactin in the body is recommended 5-8 days after the start of menstruation.

Prolactin norms

The level of prolactin in women will depend on the presence or absence of pregnancy:

By cycle phases:

It must be remembered that methods for detecting prolactin levels may differ in different laboratories. Accordingly, the results of this survey may be different. As a rule, in all medical institutions, along with the test results, an insert is attached indicating the standards that are relevant for the given laboratory. Sometimes for one laboratory a level of 36 is the norm, but for another it is already 20. Therefore, be careful!

Reasons for increased prolactin

In many cases, an increase in the level of the hormone prolactin does not indicate the presence of some pathological process, but the possible impact of the following factors:

• pregnancy (the level of this hormone begins to increase rapidly from 8 weeks after conception);
• stress;
• breast-feeding;
• improper preparation for a blood test for prolactin levels (in this case, a repeat test may be prescribed during the next menstruation);
• use of recreational drugs;
• the use of certain medications (hormonal drugs increase to 100ng/ml, and drugs that are intended to treat mental or gastrointestinal disorders raise prolactin levels above 200ng/ml).

If the increase in hormone levels is caused by medications, then after they are discontinued, the level returns to normal within 3-4 days.

Also, prolactin levels may increase during the development of the following diseases:

• Anorexia. A mental disorder that is characterized by partial or complete refusal to eat food, as well as a constant lack of appetite.
• Prolactinoma. A benign pituitary tumor that causes excessive production of prolactin. During prolactinoma, the level of the hormone prolactin in the blood becomes more than 100 ng/ml. In addition, the following clinical manifestations may be symptoms of this disease: obesity, visual impairment, amenorrhea, galactorrhea, infertility in women, nausea, headaches. To confirm or refute this diagnosis, the following types of examination are performed: nuclear magnetic resonance (NMR), as well as computed tomography (CT).
• (PCOS). This disease affects the female genital area, resulting in pathological changes in the functions and structure of the ovaries. This disease is characterized by the occurrence of infertility, excessive growth of body hair (occurring due to the production of a large amount of male sex hormones), the appearance of acne, depression, irritability, drowsiness, lethargy, and menstrual irregularities.
• Hypothyroidism. The cause of this disease is a severe decrease in the level of thyroid hormones. The main clinical manifestations of hypothyroidism: bags under the eyes, drowsiness, menstrual irregularities, dry skin, loss of appetite, depression.
• Liver cirrhosis, kidney disease, hypothalamic tumors, lung malignancy, etc.
• Chest injury.

Ways to reduce prolactin levels

There are several methods for treating increased prolactin in the blood, the use of which directly depends on the reason that caused the increase in this hormone:

• drug treatment (prescribed for prolactinoma or hypothyroidism);
• radiation therapy (if a tumor occurs);
• surgical intervention.

Decrease in prolactin

Most often, a low level of prolactin in the blood is not an indication for any treatment. In non-pregnant women, the level of this hormone may be reduced, but is still within normal limits.

• head injury, which causes disruption of the pituitary gland;
• pituitary tumors;
• consequences of radiation therapy;
• pituitary tuberculosis.

Also, a decrease in prolactin can be caused by long-term use of certain medications.

Prolactin (mammotropin, lacto-, luteotropic hormone, lactogenic hormone, mammotropin, LTG) is a polypeptide hormone produced by the adenohypophysis (the anterior lobe of the pituitary gland, its lactogenic cells). The level of the hormone rises during sleep and falls upon awakening. This hormone is present in the blood in several forms - monomeric prolactin (post-PEG), has one peptide chain - the most active; di- and tetrameric - inactive or with low bioactivity.

When analyzing blood, only the concentration of the monomeric form is important, since only it is biologically active. Its main organs of influence are the reproductive and reproductive systems, i.e. all its effects are related to fertility. The main organ for the action of mammotropin is the mammary glands. In addition to the breast, prolactin receptors are found in almost all other organs, but the effect of this pituitary hormone on them is not yet known.

Prolactin is necessary and can increase for lactosecretion and colostrum after childbirth, helps the maturation of colostrum, turning it into full-fledged milk. It enlarges the lobules and ducts in the mammary glands, stimulates their growth, due to which the mammary glands become enlarged and filled with milk.

Helps with the normal course of pregnancy, childbirth, and delays ovulation in the first 6 months of breastfeeding to prevent another pregnancy. The same hormone:

• protects the fetus from attacks of maternal immunity;
• has an analgesic effect and stimulates progesterone production during gestation;
• promotes the formation of maternal instinct;
• protects breast cells from malignant degeneration;
• participates in the work of lymphocytes during inflammation processes, in the appearance of orgasm during intimacy;
• participates in the development and formation of the child’s respiratory organs, in electrolyte metabolism;
• regulates the luteal phase of MC.

Like any hormone, mammotropin is prone to fluctuations - it happens that prolactin is increased or decreased for various reasons. This immediately affects the human condition. LTG is not only significant for women; in men it also performs certain functions.

The work of prolactin in men:

• participation in spermatogenesis;
• affects potency and libido;
• regulates immunity.

What else does prolactin affect in men? It is involved in the formation of viable sperm, increases testicular weight and stimulates the prostate. Normalizes the functioning of the nervous system and all internal organs; the mechanism of this effect is not clear.

Reasons for the increase

The reasons for the increase in prolactin should always be known, because prolactin when increased:

• causes infertility, MC disturbances, PMS;
• promotes the appearance of hormone-dependent tumors of the uterus and breast.

Hyperprolactinemia: what is it and its causes? An increase in prolactin in the blood is called hyperprolactinemia. When the cause of hyperprolactinemia is not clear, it is idiopathic hyperprolactinemia.

The reasons for the increase are physiological and pathological. In physiology (healthy person), everything is done without treatment; only dynamic observation is necessary.

The reason for the occurrence of increased prolactin according to physiology:

• pregnancy and lactation;
• stress;
• newborn age (up to 1 month of life);
• drinking alcohol;
• strict diets with hypoglycemia. Prolactin also increases during physical activity or training;
• nipple stimulation;
• smoking;
• neck massage (there are many nerve nodes here).

Prolactin levels increase when visiting a sauna, steam baths, severe algia, lack of sleep, intimacy. Why is prolactin high? From taking psychotropics and drugs, COCs, sleeping pills, long-term use of antibiotics.

There are also herbs that cause excess prolactin: red clover, fennel, fenugreek. To avoid nipple irritation, underwear should be the right size. Prolactin also increases with aging, which is accompanied by decreased vision and hearing.

Pathological causes of hyperprolactinemia:

• neoplasms and pathologies of the hypothalamus;
• systemic chronic diseases;
• autoimmune diseases;
• disorders in the adenohypophysis (anterior pituitary gland);
• brain infections;
• thyroid pathology (hypothyroidism);
• PCOS;
• acute renal failure and decreased adrenal function;
• cirrhosis of the liver.

Pathological hyperprolactinemia (increased prolactin) is divided into: functional and organic. Functional includes the consequences and complications of certain diseases: liver cirrhosis and acute renal failure, sarcoidosis and TB, hypothyroidism, PCOS, bruises and injuries to the head and chest; functional hyperprolactinemia does not produce organic changes.

In organic cases, the pathologies that arise themselves lead to changes in tissue morphology: tumors produce prolactin higher than normal - prolactinoma, germinoma, glioma, pituitary adenoma, meningioma. Hyperprolactinemia is 10 times more common in women.

Symptoms of elevated prolactin

Hyperprolactinemia: Symptoms vary by gender. Among women:

• anovulation or its failure occurs;
• there is no conception and infertility occurs;
• symptoms of increased prolactin in 90% of cases are expressed in violations of the regularity of circulatory cycles - amenorrhea is observed for six months or more;
• galactorrhea (often for years);
• for the same reason acne appears; hirsutism;
• weight gain;
• decreased libido and frigidity; osteoporosis;
• prolactinoma.

Elevated prolactin levels are problematic in that even if such a woman manages to become pregnant, the fetus will be aborted after 2 weeks.

Prolactinoma is a benign pituitary tumor that is active and produces prolactin in excess. Hyperprolactinemia syndrome worsens memory, vision, and mood, the person becomes absent-minded, cephalgia and difficulty falling asleep appear.

Osteoporosis - during lactation, excess prolactin causes loss of calcium from the bones.

In men, increased prolactin - signs and symptoms:

• weight gain and gynecomastia;
• the body is covered with dotted raw materials;
• hair on the body and face becomes sparse;
• with increased prolactin, a man becomes apathetic;
• hyperhidrosis;
• erection and potency weakens;
• libido decreases;
• infertility develops;
• There is a strong deposition of fat on the waist and hips;
• an increase in insulin develops;
• appetite increases and weight gain occurs;
• Rarely, diabetes may develop.
• High prolactin levels in 20% of cases increase cholesterol and heart problems; the patient notes weakness and rapid fatigue.

Increased content and excess of prolactin in 15% of patients causes destruction of adenohypophysis cells. Vision drops sharply, the optic nerve swells and severe cephalgia appears; ICH increases. Often the patient becomes drowsy, and the skin of the face turns red for no reason.

General symptoms:

• increased incidence of fractures;
• hyperglycemia;
• multiple caries;
• Insomnia is very common;
• depressed mood.

The effect of dopamine is neutralized.

What medications cause prolactin to increase when taken? These are OK, antidepressants and neuroleptics (Haloperidol), antiemetics (Cerucal, Motilium), antiulcer drugs (Omeprazole), dopamine receptor blockers - domperidone, bromopride; antihypertensive - reserpine; amphetamines; antiarrhythmic drugs – verapamil; cocaine and opiates (morphine, promedol).

Features of hyperprolactinemia in women

Prolactin is slightly at the upper limit of normal - it happens during the ovulation phase. A surge in the hormone is observed in the 3rd trimester of gestation; it exceeds the norm by 3 or more times.

Before childbirth, it decreases and immediately increases again in postpartum women. At the same time, colostrum turns into milk.

Elevated hormone prolactin – why is it dangerous? Prolactin decreases with menopause and tumors of the uterus and breast are often possible - while PRL increases. It is believed that this is the work of estrone (bad estrogen), which stimulates the synthesis of PRL. Women are more likely to have brain tumors.

Features in men

Hyperprolactinemia syndrome causes a decrease in immunity, and chronic prostatitis often forms; at the same time the potency decreases. Consequences of increased prolactin in men: leads to cirrhosis of the liver and pituitary adenoma. This benign tumor most often develops after 49 years of age. Macroprolactinomas may develop. Often the cause of the hyperprolactinemic state remains unclear, then they talk about idiopathic hyperprolactinemia, which also requires treatment.

LTG norm

The norm of prolactin in men is lower than in women: 2.5–17 ng/ml, or 75–515 µIU/l. The lowest normal value in women is 4.5 ng/ml - during the follicular phase; the highest (49 ng/ml) - in the second, ovulatory phase. During conception and gestation, the level of luteotropic hormone LTG constantly increases and can rise to a peak (386 ng/ml) at 21-25 weeks.

Then it gradually decreases, but remains elevated two to three years after lactation and immediately during it. The increase in prolactin levels constantly fluctuates; it can physiologically increase in the morning, after exercise, from tactile touch to the nipples, at high temperatures, due to stress, after sex.

Getting tested for prolactin

A test is prescribed for a man if he has 2-3 specific symptoms. The study is carried out using the immunoassay method. In commercial centers, the test is called a prolactin test.

What to do to prepare for the correct passing? A day before donating blood, sex, hypothermia, overheating in the form of visiting a sauna, physical activity, and stress are excluded; in the evening, a light dinner, without protein. Give up alcohol within 2 days. On the day of the test in the morning, 2-3 hours before blood sampling, do not smoke, do not have breakfast, and do not touch the nipples.

Blood sampling is carried out 2-3 hours after sleep, no later than when prolactin reaches its highest level; preferably between 7 and 11 o'clock. Indicators should only be looked at as reference ones. Women donate blood to phase 1 of the MC. If the diagnostic indicators of prolactin are higher than normal (from 40 to 600 mU/l in fertile age and in the range of 25-400 mU/l during menopause), the diagnosis without difficulty indicates hyperprolactinemia.

Due to the instability of hormone values, the test is performed several times. A man can have 3 types of test results and the diagnosis is different: macroprolactinemia, true hyperprolactinemia and a questionable result.

In macro cases, no treatment is required; this condition is safe for men. The second option requires additional examination and the final diagnosis is postponed. If the answer is questionable, the analysis is retaken.

LTG and other sex hormones

LTG, testosterone and estrogen are all closely related. An increase in estrogen results in an increase in PRL and a decrease in testosterone. Symptoms of all these hormones cause sexual dysfunction and changes in secondary sexual characteristics.

Principles of treatment

When prolactin is increased, the choice of treatment depends on the etiology. It is not carried out if the weight is N, the pituitary structures are not damaged, and the reproductive system is normal. Prolactin can be lowered by different types of treatment: taking medications, radiation treatment and surgery. If surgery is impossible, or the patient refuses surgery, then prolactin irradiation is used. Radiation therapy provides equally effective results.

Drugs to reduce prolactin: those that reduce prolactin in case of pituitary microadenoma or functional increases in the hormone - taking dopamine agonists. The level decreases after 3-4 weeks. The course of treatment is from 6 to 27 months. BBT is measured regularly and prolactin tests are taken. For pituitary macroadenoma, treatment is carried out by a neurosurgeon.

Reduce and lower the level of prolactin: prolactin in case of adrenal insufficiency requires the use of corticosteroids, HRT, in case of thyroid hypofunction - eutirox. Only if there is no effect from the pills, a radical method or radiation therapy is used. These methods have a negative side - the substance of the pituitary gland and blood vessels of the brain are damaged.

How to reduce prolactin?

First you need to change your work and rest schedule and get enough sleep. How to reduce prolactin further? Start taking Vit. B6 to normalize cerebral blood flow. If it is necessary to use anabolic steroids, use antiestrogens.

Hyperprolactinemia is treated with the use of dopamine receptor agonists: Parlodel, Bromocriptine, Abergine, Cabergoline, Quinagolide, Pramipexole, Apomorphine - they all contain ergot alkaloid. How to treat elevated prolactin? Taking eutirox will lead to a decrease in the level of hyperprolactinemia.

How can hypothyroidism and high prolactin be related?

Hyperprolactinemia is often caused by hypofunction of the thyroid gland, the proportions between them are the opposite. With hyperprolactinemia, testosterone decreases, so HRT is prescribed. Treatment of elevated prolactin is supplemented with hepatoprotectors, diuretics, calcium compounds and vit.D.

Use of medications - treatment is often carried out with tablets. The main drug used was Bromocriptine. It gives an improvement in 4 out of 5 cases.

When the drug is discontinued, all symptoms return - the attending physician should warn the patient about this. Side effects of Bromocriptine: nausea and vomiting, orthostatic collapse, migraines, difficulty falling asleep and nightmares. These manifestations occur if treatment is started with excessive doses of the drug. Most often they occur at the beginning of treatment and then go away. Therefore, treatment begins with small doses.

Parlodel is an analogue of Bromocriptine - treatment begins with 4 mg per day, then the dose is doubled and reaches 8 mg. Cabergoline is easier to tolerate and highly effective.

Herbal preparations

Hyperprolactinemia: how to reduce it – treatment is also carried out with herbal preparations. Cyclodinone is an extract from the fruit of Vitex sacred. The drug affects the lactotrophs of the pituitary gland, effectively reduces and normalizes PRL.

Mastodinon is a homeopathic herbal preparation. It improves the condition of mastopathy, prevents a surge in hormonal levels by normalizing the psycho-emotional state. The product is well tolerated and safe.

Surgical intervention

Prolactin is increased: how to reduce it? Surgery is also performed if other treatment methods are ineffective and the means are ineffective. As the tumor grows, it can compress nerves and blood vessels, and a person can lose vision and hearing. The diagnosis is made on the basis of an MRI. The operation does not provide a 100% guarantee; in 43% there are relapses.

Preventive actions

You should not stay in the sun for a long time - UV irradiation increases the increase in prolactin. You should normalize your weight, it is better to quit smoking or reduce the number of cigarettes you smoke. It is better not to take sleeping pills, go to bed no later than 10 pm, and change your diet.

Rest should be active, and a course of vitamins should be taken periodically. It is advisable to make daily walks mandatory.