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Prolactin is the hormone responsible for stimulating the mammary glands to produce breast milk during pregnancy and during breastfeeding. Therefore, high blood prolactin may be a sign of pregnancy, and it is recommended to take a pregnancy test to confirm. Outside pregnancy, prolactin is also responsible for regulating other hormones, having a fundamental role in ovulation and menstruation.
However, in other cases the increase in prolactin in the blood may happen due to the use of some drugs or endocrine changes, that is, involving the gland responsible for the production of this hormone.
Symptoms of high prolactin
In case of high prolactin in women, symptoms such as:
- Delay or absence of menstruation for more than 35 days in each cycle;
- Breast milk production, even without being pregnant or having a baby recently;
- Decreased libido;
- Infertility, having difficulty getting pregnant for long months or years;
- Osteoporosis may occur, with a 25% decrease in bone mass in the spine.
In men, increased prolactin can cause symptoms such as:
- Exit of milk through the man's breasts;
- Decreased libido;
- Erectile dysfunction;
- Decrease in testosterone production;
- Decreased sperm production;
- Infertility;
- Breast augmentation;
- Osteoporosis.
Other symptoms commonly found in both women and men are headache and changes in vision. Learn all about the increase in prolactin in men.
Causes of elevated prolactin
Elevated prolactin may be related to:
- Pregnancy or breastfeeding;
- Intense physical exercise;
- Accumulated sleep and psychological stress;
- Breast stimulation;
- Polycystic ovary syndrome;
- Use of antidepressant drugs or remedies for seizure, anesthesia, allergy, high blood pressure, estrogens, nausea;
- Primary hypothyroidism;
- Head or chest surgery or trauma to these sites;
- Addison's disease or diseases such as acromegaly, hypophysitis or adenoma;
- Brain tumor;
- Exposure to radiation in the head region.
In women in about 30% of cases of increased prolactin, unrelated to pregnancy or breastfeeding, it is due to Polycystic Ovary Syndrome, or due to the presence of a small tumor less than 10 mm in diameter, which very rarely increases in size and that cannot always be seen on an MRI scan. Learn more about Polycystic Ovary Syndrome.
How to download prolactin
Treatment to normalize prolactin values is indicated when symptoms are unpleasant and impair the person's life.
In cases where the cause is the use of medicines, you should talk to the doctor to check the possibility of exchanging for another medicine that does not interfere with the production of prolactin.
It is also important to start treatment when the couple has the desire to become pregnant, but it has not been possible due to infertility. Certain couples are able to get pregnant with values of 50 to 60 ng / mL, but it may be necessary to lower these values even further with the use of drugs such as Dostinex or Parlodel, for example, because high prolactin increases the risk of miscarriage.
When the cause is a tumor, treatment with medications, such as Cabergoline and Bromocriptine, which usually reduce their size, should be performed in approximately 2 years and in rare cases, surgery, and sometimes radiotherapy, may be necessary. it is only indicated for aggressive or malignant tumors.
Reference values
The reference values for prolactin may vary according to the laboratory in which it is performed and the method of analysis, so it is important to pay attention to the reference values indicated in the test result. In general, the reference values for prolactin are:
- Non-pregnant and non-pregnant women: 2.8 to 29.2 ng / mL;
- Pregnant women: 9.7 to 208.5 ng / mL;
- Postmenopausal women: 1.8 to 20.3 ng / mL;
- Men: below 20 ng / mL.
When prolactin is above 100 ng / mL the most common cause is the use of drugs or the presence of micro tumors, and when the values are above 250 ng / mL it is probably a larger tumor. If a tumor is suspected, the doctor may choose to repeat the prolactin test every 6 months for 2 years, then perform only 1 test per year to check for any changes.
How to prepare for the exam
In order to perform the prolactin test more correctly, some precautions must be taken, such as drawing blood at least 1 hour after waking up and having breakfast. Usually 1 exam is enough to identify changes in prolactin, but when the result is between 20 and 60 ng / mL, the doctor may find it safer to do one more test to confirm the result.