If the hormone prolactin is elevated, then the menstrual cycle and hormonal background are disrupted, and infertility or problems with bearing a child arise. Therefore, women need to determine their level in their blood when planning pregnancy.
Prolactin is produced by the pituitary gland - the endocrine gland located in the brain. The hypothalamus controls this process. The hormone level is very sensitive to external factors. So, high prolactin may be for the following reasons:
On various days of the cycle, the level of the hormone in the blood varies from 6 to 28 ng / ml. To obtain reliable results, you can not take analysis after sleep or procedures. Prolactin secretion occurs in a pulsed fashion, with the frequency depending on the phase of the cycle. There are also daily fluctuations in its level, for example, after awakening, the hormone concentration is the lowest. After falling asleep, its secretion increases and builds up in a dream.
In a third of patients in whom prolactin is elevated, pituitary adenoma is detected. If its size is large, then the level of the hormone is more than 100 ng / ml. Smaller indicators can be with microadenomas of small sizes that are not detected by x-ray.
The most informative method for the diagnosis of pituitary neoplasms is MRI. It is necessary to go through it when planning a baby, if there is a suspicion of the presence of adenoma, since a large neoplasm can contribute to complications.
The dimensions of the pituitary microadenomas do not exceed 1 cm. They grow very slowly and, as a rule, are benign. The diameter of the macroadenomas exceeds 1 cm. They are accompanied by headaches, a change in the field of view, and sometimes its complete loss. If macroadenoma is detected, it is necessary to consult a neurosurgeon. He decides on surgery. During pregnancy, microadenomas, as a rule, do not change, but large neoplasms in 20% of cases grow.
Also, prolactin is often elevated in renal failure (chronic). During kidney transplantation, its secretion is normalized.
If prolactin is elevated, the treatment goals are as follows:
- reduce the size of the tumor, if any.
One of the drugs used to lower the hormone is bromocriptine, which is a dopamine agonist. It inhibits prolactin secretion by stimulating receptors in the brain. Doses of the drug depend on the severity and nature of the disease. After the start of bromocriptine administration, the cycle is restored on average after 7 weeks. Although in some patients this happens after a few days.
Bromocriptine is usually taken several times a day. If necessary, the dose may be increased. Treatment should be continued for several cycles after the restoration of menstruation to prevent relapse. Side effects of bromocriptine:
Hypothyroidism can lead to increased prolactin. Reception of homons in this case leads to normalization of its level.
Indications for the appointment of analysis for prolactin are as follows:
- decreased potency and libido;
- discharge from the nipples;
- amenorrhea, oligomenorrhea;
Thus, prolactin is elevated in most cases due to pituitary adenoma. In addition, hypothyroidism is a common cause of its high concentration. An increased concentration of prolactin leads to a violation of menstrual function and the absence of ovulation, therefore, conceiving and bearing a child becomes almost impossible. Treatment consists in reducing its level, eliminating the cause of the disease and restoring the cycle.