Prolactin is a hormone that is produced in the pituitary gland located in the brain. For both women and men, the level of this hormone in the blood is extremely important. Its content in the amount above the norm practically negates the functioning of the human reproductive system. A woman will not be able to become pregnant, and a man may decrease libido and develop impotence.
In order to solve this problem, special medical preparations have been developed, one of which is Dostinex. Reviews with increased prolactin characterize this tool as very effective.
What is Dostinex?
“Dostinex” is a drug designed to combat hyperprolactinemia and various diseases caused by it and combined with it. That is, the medication will be effective in such problems as amenorrhea (lack of menstruation for several cycles), infertility, galactorrhea (milk production from the mammary glands, not related to feeding the baby), prolactin-secreting pituitary adenoma, acromegaly (impaired functioning of the anterior pituitary gland , which is accompanied by a thickening of the hands, feet, skull).
The main component of the drug is cabergoline, lactose and leucine act as auxiliary components. Dostinex release form - 0.5 mg tablets, in one package - 8 pieces. The essence of the action of the drug is to block the production of prolactin, which, for example, in the female body makes it possible to mature the follicle in a timely manner and restore the menstrual cycle. As a result, normal ovulation occurs, a woman has a chance of pregnancy.
Blood Prolactin Level
When elevated prolactin is found in the blood after taking hormone tests , Dostinex treatment is the most commonly used therapeutic regimen. As for women, it is recommended to take blood for analysis from the 3rd to the 8th day of the menstrual cycle (countdown - from the first day of menstruation). The analysis should be taken on an empty stomach, preferably no later than 2-3 hours after awakening. Before taking the test, it is recommended to exclude large physical exertion, avoid stressful situations, refuse sex, do not eat sweets.
In human blood, prolactin is contained in several forms. The monomeric form of this hormone is the largest fraction - up to 80%. Dimeric prolactin is contained in an amount of 5 to 20% of the total volume of the hormone, and tetrameric - not more than 5%.
The following indicators of the level of prolactin in the blood are considered normal in the medical environment:
• for women who are not pregnant - 4-49 ng / ml (fluctuations depending on the phase of the menstrual cycle are permissible);
• for pregnant women - 34-386 ng / ml (fluctuations depending on the duration of pregnancy are acceptable);
• for men - 2.5-17 ng / ml.
Symptoms and causes of increased prolactin in women
Once the fact of increased prolactin is established, certain studies are needed to establish the causes. That is, before recommending Dostinex with elevated prolactin, the attending physician usually appoints his patient to have a brain tomogram, X-ray, fundus examination, etc.
As a rule, in most cases, the following factors are the cause of the increased content of the hormone prolactin:
• The presence of prolactinoma (a tumor in the pituitary gland - usually benign - that produces prolactin in large quantities).
• Polycystic ovary.
• Hypothyroidism - insufficiency of the production of hormones by the thyroid gland.
• Anorexia (lack of weight) and some other problems of internal organs.
Typically, a woman's body signals an increased level of prolactin with a certain set of symptoms. Of the most frequently noted - deviations in the menstrual cycle, weight gain, rapidly occurring fatigue, the development of depression, sleep disturbances.
Further, patients talk about the appearance of acne and excessive hair growth in places not characteristic of the female body (face, area around the nipples, etc.). Discharges from the mammary glands and the developed infertility resulting from the absence of ovulation or the too short luteal phase are also good reasons for the doctor to prescribe Dostinex. Reviews with increased prolactin in women most often have a positive orientation and indicate the effectiveness of the drug.
Symptoms and causes of increased prolactin in men
Unlike women, men have a high level of prolactin in the blood is secondary in nature - this is most often a consequence of an existing problem. In the presence of a factor such as increased prolactin in men, Dostinex is prescribed for use in parallel with the drugs recommended by the doctor to combat the identified disease.
Diseases such as prolactinoma (a brain tumor, most often benign, producing prolactin), hypothyroidism (decreased thyroid function), severe (with impaired functioning) liver and kidney diseases, and a decrease in adrenal cortex function can cause an increase in prolactin levels in representatives of the stronger half kind of disease and brain tumor. In addition, an increase in prolactin levels in men can be triggered by the use of certain medications - opiates, antipsychotics, antidepressants, etc.
The main symptom of an excess of this hormone in the blood in men is the same as in women - a violation of reproductive function, in most cases accompanied by deviations in fat and carbohydrate metabolism (obesity). A man's sex drive decreases, and symptoms of impotence develop. Sometimes an increase in the mammary glands and a small discharge of them are recorded.
If the cause of hyperprolactinemia is prolactinoma, then various manifestations in the field of neurology appear early enough. It can all start with headaches, dizziness and a slight decrease in vision. If no measures are taken to resolve the problem, over time, paralysis of the oculomotor muscles, drooping eyelids, double vision, and the like develop. In parallel with these symptoms, the patient's working capacity decreases, irritability, anxiety, a tendency to depressive states, inability to concentrate, memory loss appear. Often men develop type 2 diabetes, atherosclerosis. The doctor may consider all these symptoms to be sufficient grounds for prescribing Dostinex medication. Reviews with increased prolactin in men indicate a good effect from the use of the drug, subject to the recommendations of the doctor.
Dostinex and pregnancy
In general, women of reproductive age should know that pregnancy is one of the main contraindications for using the Dostinex product. Reviews with increased prolactin (pregnancy itself is the cause of a gradual increase in the level of prolactin in a woman’s blood), no matter how positive they may be, should not mislead a woman.
The level of prolactin in the body of a woman carrying a child begins to grow gradually, starting from the 8th week and reaching maximum values by a period of 20-25 weeks. This hormone, in addition to preparing the woman’s mammary glands for future feeding of the baby, also has a strong influence on the formation of the lung tissue of the developing baby.
Before starting treatment with Dostinex, it is necessary to exclude the presence of pregnancy and use mechanical methods of contraception throughout the course of treatment. If the fact of pregnancy is registered against the background of the course of treatment that has begun, you should stop taking Dostinex.
The half-life of cabergoline (the main active component of the drug) is quite long. Therefore, if a woman is planning a pregnancy in the future, Dostinex should be discontinued no later than 1 month before the proposed conception in order to exclude the possibility of negative consequences for the fetus.
Schemes for the use of medication
The doctor should inform his patient about how to drink Dostinex with elevated prolactin. The standard regimen for taking this medication is one (maximum two) times during the week, with meals. If the reason for the appointment of Dostinex is hyperprolactinemia, the maximum volume of the drug should not exceed 4.5 mg during the week (should be divided into several doses). After the start of the course of therapy, patients should monitor the level of prolactin in the blood and monthly take appropriate tests. Usually, the indicators return to normal after 2-4 weeks from the start of treatment.
In the event that a woman for some reason wants to prevent postpartum lactation, she is prescribed 1 mg of the drug once on the first day after birth. How to take Dostinex with increased prolactin if the lactation process is already established?
To stop it, the doctor usually recommends 250 μg of the drug every 12 hours for 2 days. With this mode, side effects in the form of arterial hypertension are less common.
Negative manifestations
In the bulk of cases about the Dostinex medication, reviews with elevated prolactin are positive. The drug is considered to be highly effective among medical workers, almost not causing side effects. Nevertheless, some negative effects are observed. Quite often you can hear about lowering blood pressure, headaches pain and dizziness, insomnia, nausea and pain in the gastrointestinal tract.
Naturally, there are also negative reviews about Dostinex with elevated prolactin. Side effects can be manifested in the development of gastritis, vomiting, constipation, in the appearance of drowsiness and weakness, in the "flushing" of blood in the face, in the appearance of depression and paresthesia, in the painful tension of the mammary glands.
True, it is worth saying that all these manifestations are almost never pronounced. Most side effects are observed at the very beginning of treatment - during the first two weeks. If the dosage is slightly reduced, the negative symptoms will disappear. After which you can again gradually increase the dose to effective. With the complete abolition of Dostinex, the negative symptoms will disappear within 1-2 days.
Contraindications to the use of Dostinex, overdose
This drug has few contraindications, but they are. Firstly, hypersensitivity to the components of the drug (including all ergot derivatives). Secondly, pregnancy. The question of how to drink Dostinex with increased prolactin during pregnancy is not at all worth it - this is unacceptable for a woman who is expecting a baby. In addition, the medication should not be taken during lactation, if the woman does not have any good reason for the emergency termination of this process. Further, doctors do not recommend taking Dostinex to those women in labor who have postpartum hypertension and postpartum psychosis (even in the anamnesis).
With great caution and under constant monitoring, patients with cardiovascular problems, with Raynaud's syndrome, renal and hepatic insufficiency, with stomach and duodenal ulcers, and bleeding in the gastrointestinal tract should take medication to their state of health.
Do not prescribe the drug also to those patients who have a history of mental illness.
In order to prevent exceeding the maximum possible dose, the question of how much and how to take Dostinex with increased prolactin should remain under the supervision of the attending physician. The presence of such conditions as abdominal pain, nausea and vomiting, sudden general weakness, drowsiness, sweating, calf muscle cramps, psychomotor agitation, the development of psychosis, the appearance of hallucinations testifies to the fact of an overdose. As therapeutic measures to eliminate the consequences of an overdose of the drug, gastric lavage, constant monitoring of blood pressure and the use of dopamine antagonist medications are recommended.
Special information
If taking Dostinex with elevated prolactin is ineffective, then the cause of the development of hyperprolactinemia in this particular patient should be sought in another area.
Women in the case of treatment with this drug for a long period of time should undergo a regular gynecological examination with a mandatory cervical gynecological examination and histological examination of the endometrium.
During the treatment with Dostinex, it is necessary to constantly monitor blood pressure and the functioning of the gastrointestinal tract due to the potential risk of bleeding. In addition, patients taking Dostinex (reviews with increased prolactin draw attention to such facts) should not be engaged, or at least for some time should refrain from engaging in potentially dangerous activities that require a high concentration of attention and an increased speed of psychomotor reactions .
Patients' opinion about the drug
As mentioned earlier, Dostinex is a modern and highly effective drug that does not cause severe side effects. The main contingent of patients taking this drug is women. The most common reasons for prescribing this medication are the presence of prolactinomas, the inability to become pregnant and the cessation of prolonged lactation. In all these cases, the Dostinex testimonial with elevated prolactin is positive. The drug inhibits the development of prolactinoma (and in men, too), helps women to quickly end the period of prolonged and abundant lactation without the threat of mastitis and the need to dress the breast. Women who could not become pregnant due to, as it turned out, a high level of prolactin, significantly exceeding the norm, say that the indicator reached a physiological norm within 2-4 weeks, and after the cancellation of "Dostinex" a long-awaited pregnancy occurred.
There are, of course, reviews about the negative reactions to the use of Dostinex. However, side effects almost never have a pronounced character and quickly disappear on their own when the drug is discontinued or the dose is reduced.