HIGH PROLACTIN or HYPERPROLACTINEMIA: symptoms and causes

Hyperprolactinamia or high prolactin
The feedback from high prolactin at analysis of the blood it is a condition called hyperpolactinemia. The main symptoms of high prolactin I'm there galactorrhea and the reduction of sexual desire in man, e infertility in women.
The causes of high prolactin are related to the presence of a pregnancy or a adenoma pituitary gland producing excess prolactin. Even quite physiological conditions like it stress or the fatigue they can affect serum prolactin levels.

High prolactin

What is prolactin? There prolactin it's a hormone produced byanterior pituitary and is mainly involved in the production of the milk during the period of pregnancy and post-partum. Prolactin also affects the growth of the pubertal age otherwise along with another group of defined hormones estrogen.
Considering its function, it could be believed that this hormone is purely female, while prolactin is present in both women and men. The alteration of the prolactin values indicates that something in the body is not working properly, and is an alarm bell which must always be followed by a thorough investigation into the causes of this rise.

Prolactin normal values

The blood levels of prolactin can be detected through a simple blood sample, and generally must fall within these reference values:

  • In NON pregnant women: <25 ng / mL
  • In pregnant women: 34-386 ng / mL
  • In men: <15 ng / mL

Considering that prolactin can undergo considerable variations even after a few days, in case of high values it would be useful to repeat the test at least one more time to be sure that the result obtained is real, and that it has not been influenced by factors frequent and not particularly worrying such as fatigue or stress.

In the event of hyperprolactinaemia, it may be advisable for women to carry out a pregnancy test after consultation with a doctor and on the prescription of their doctor. In addition, the opportunity to deepen the analyzes with a CT (computed tomography) of the skull, to evaluate the pituitary gland and rule out the presence of a pituitary adenoma.

There are also ultrasound signs that highlight physiological conditions typical of high prolactin.
Among the signs that can be revealed by aultrasound of the abdomen from a'transvaginal ultrasound they could be:

  • the uterus smaller than the norm;
  • the endometrium tending to thin;
  • the uterine parenchyma (ie the tissue that makes up the uterus) may be hyperechoic, that is, it appears more reflective and brilliant ultrasonographically, and of lighter color than normal.
  • the ovaries appear small with a homogeneous appearance, with few follicles;
  • presence of hydrometra, remains an extremely rare sign and is nothing more than the accumulation of mucus in the cervical cavity of the uterus.

Obviously if you are faced with abnormal prolactin values the first thing to do, at least in women, is to exclude a state of pregnancy. The feedback from high prolactin in men instead it is always worrying and therefore must be investigated as soon as possible.

Hyperprolactinamia or high prolactin

Here is the negative feedback mechanism of female sex hormones and prolactin.

High Prolactin Causes

What are the causes of hyperprolactinemia? There are several reasons why prolactin was elevated on blood tests. The main causes of high prolactin I'm:

  • pregnancy: during pregnancy, prolactin levels rise significantly. Furthermore, after childbirth, the high levels of prolactin associated with the sudden decrease in estrogen from progesterone triggers the lactation, causing the mammary glands to be able to produce milk.
  • stress: Excessive psychological stress (work stress, bereavement, separations) or particularly stressful situations from the physical point of view such as fasting, anorexia nervosa, myocardial infarction, the presence of burns, can contribute to causing an increase in prolactin
  • sport: intense sporting activity can cause the secretion of this hormone to increase, especially after strenuous physical exercise
  • chest injuries
  • polycystic ovary syndrome: or ovarian polycystosis (PCOs) It is a condition characterized by enlarged and micropolicistic ovaries (with multiple small cysts) and by endocrinological and metabolic alterations such as hirsutism (increased hair) and alterations in menstruation up to infertility. This syndrome can lead to hyperprolactinaemia in some cases.
  • hypothyroidism: Thyroid dysfunctions with elevated TSH and hypothyroidism may accompany a elevated prolactin
  • drugs: the intake of antihypertensive drugs such as methyldopa, psychotherapy with drugs active on the central nervous system such as antidepressants, anticonvulsants, antipsychotics such as amisulpiride (Deniban); hormone therapy with estrogen, the use of drugs for gastrointestinal disorders, are all factors that can determine hyperprolactinemia
  • pituitary adenomas, are benign tumors of epithelial origin which are the most frequent cause of hyperprolactinaemia in women, and are responsible in total for about 30% of cases of elevated prolactin
  • pituitary disorders (or pituitary gland)
  • kidney failure
  • cirrhosis of the liver
  • addison's disease that is a chronic adrenocortical insufficiency resulting from a permanent and irreversible reduction of the secretion of the hormones produced by the adrenocortical, can imply an alteration of the hormone prolactin secondary to an exaggerated pituitary activity
  • excessive stimulation or sucking of the nipples, they increase prolactin by a positive feedback mechanism
  • sleep wake rhythm: habits are also responsible for changes in plasma prolactin levels, as the reduction of sleep can favor its increase. The stimulation of the retina that occurs during wakefulness reduces the production of melatonin favoring the increase in the secretion of prolactin.

High Prolactin Symptoms

What are the symptoms of hyperprolactinemia? The diagnosis of hyperprolactinemia can sometimes be difficult, but the symptoms that arise with hyperprolactinemia are often evident.

THE signs is main symptoms that occur with an overproduction of the hormone prolactin are:

  • galactorrhea or the discharge of milk secretions from the nipple
  •  amenorrhea or the lack of menstruation for one or more menstrual cycles
  • presence of multiple ovarian cysts
  • hypogonadism, i.e. inadequate secretion of sex hormones (i.e. testosterone in men and progesterone and estrogen in women) by the gonads
  • the secretion of milk from the breasts without being pregnant
  • breast turgor in women
  • gynecomastia ie the abnormal development of the breast in man
  • infertility for both females and males
  • erectile dysfunction in men also called impotence
  • frigidity in women, that is, a decrease in libido, or the little desire to make love
  • dyspareunia, which is a basically chronic disorder that consists of experiencing genital pain during or after intercourse
  • miscarriage
  • recurring headaches
  • visual disturbances even if everything is apparently normal
  • osteoporosis which causes weakening of the bones

High Prolactin Consequences

What are the consequences of high prolactin? When the production of prolactin is altered and this state remains constant and has no physiological causes, various consequences can occur on the organism of which the most probable is the difficulty in reproductive activities.
This happens because in humans prolactin inhibits the production of testosterone, making the various sexual functions complicated, both related to "libido" and the effective production of reproductive cells. On the other hand, in women there may be alterations in the menstrual cycle, up to even amenorrhea, with consequent difficulties in ovulation, as well as in the nesting of the embryo after the egg has been fertilized.

High Prolactin Remedies and Cures

What are the high prolactin remedies? The therapies for the treatment of high prolactin they can be of a pharmacological, surgical or radiotherapy type. The choice is made on the basis of the causes that determined this imbalance.

In the case of drug therapies, drugs are prescribed that increase dopamine production such as bromocriptine or the cabergoline which act on the pituitary and hypothalamus and reduce the production of prolactin. These drugs can cause side effects such as nausea, hot flashes, dizziness, low blood pressure and hallucinations.

Surgical therapy is used in the case of adenomas that are not controllable with drugs. In that case, an attempt is made to remove the tumor with a particular surgery carried out from the nose (transnose-sphenoid). In the last hypothesis, in addition to surgical therapy, or in place of it if not even the intervention has been able to eradicate the tumor, there is the possibility of carrying out cycles of radiotherapy.

There are those who rely on homeopathic treatments to try to reduce the production of prolactin but obviously the results obtained are null, being theabsolutely ineffective homeopathy.

In other cases, people prefer not to follow the doctors' instructions, and make an attempt with herbal medicine and phytotherapy products, which is obviously not recommended as there are no certainties about the effectiveness or possible side effects of herbal products. For the record, we would like to point out that the substances used include agnate and evening primrose.

The chaste tree which is a plant that contains essential oils and flavonoids whose extract seems to mimic the action of dopamine and, consequently, could hypothetically lead to some decrease in the production of prolactin.
The evening primrose instead it is a plant that contains fatty acids that help the body produce prostaglandins that may be able to at least partially lower prolactin levels.

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3 Comments
  1. Roberto 3 years ago

    Hi, I'm Roberto and I am 23 years old I was asking for a medical opinion regarding one of my problems, from the premise that I have had a varicocele surgery for three years and that sometimes it is still painful and I don't know why, however the problem was born before and not after the operation ... the fact is that it is three and a half years that alas the desire to have sex decreased because before the excitement was so strong that if I could not have sex I had to masturbate and unfortunately this feeling went away, I thought that it was a period of stress but the excitement has not returned anymore and those days when I feel better the situation improves only one percent compared to before, I realized that for no reason I feel sleepy and depressed. The other day I decided I went to an andrologist who had me do the hormonal and blood tests, plus he had me undergo a month-long therapy with testogel ... the results of the hormone test according to the doctor are all in the norm except for prolactin the asterisks are: (free testosterone 91 pg / ml which should be at most 30, plasma potassium 6.1 mmol / l which should be at most 5.5, mean concentration of hb (MCHC) 36, 6g / dl which the maximum value should be 35, prolactin instead is 69.4 ng / ml which should be 19 at the most). On the other hand, the therapy with testogel does not bear fruit and I do not know why ... now I would like to know your opinion about my situation and I thank you for your attention.

    • Author
      Testlevels 3 years ago

      Hi, was brain imaging done to rule out a pituitary adenoma? In any case, everything is complex and only the treating doctor can have a clear idea of the procedure to follow. Best regards

  2. Sara Balboni 3 years ago

    Hi, can the high prolactin chaste tree work?

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