What is hyperprolactinemia?

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Prolactin (PRL) is a hormone secreted by the anterior pituitary gland that stimulates the production of colostrum and the secretion of milk by the mammary glands thus allowing the maintenance of breastfeeding. This hormone is also involved in the synthesis of progesterone in the luteal phase of the menstrual cycle.

Below you have an index with all the points that we will discuss in this article.

Index

What is hyperprolactinemia?

One of the frequent pathologies related to this hormone is hyperprolactiemia that is characterized by an increase in prolactin in the blood. The normal rate of prolactin in women is around 20 ?g / l, when this rate is higher than 30 ?g / l it is considered hyperprolactinemia.

These abnormal levels of hormone in blood can alter ovulation , the menstrual cycle and produce infertility.

Sterility in women

Anovulation caused by high levels of prolactin is the most common cause of infertility in women. In 80% of cases, ovulation can be restored after 6 months of treatment with drugs (dopamine agonists).

Causes

There are several physiological situations in a woman's life that can cause a transient increase of prolactin in blood as in the luteal phase of the cycle, during pregnancy and during lactation.

Other situations are during deep sleep, physical exercise, orgasm, manipulation of the breast or stimulation of the nipples and in situations of stress.

There are also iatrogenic causes, are caused by external factors such as neuroleptic drugs, antidepressants, anxiolytics, tranquilizers, opiates (derivatives of morphine), these drugs decrease the action and synthesis of dopamine. Dopamine exerts a negative control (inhibition) on prolactin, a decrease in dopamine results in an increase in the rate of prolactin in the blood.

Oral contraceptive pills with estrogen also produce a moderate increase in circulating prolactin in the blood.

The most common pathological causes that can produce this alteration are: hypothyroidism, hyperandrogenism, anorexia nervosa, chronic renal failure, polycystic ovarian syndrome (PCOS), repeated psychological stress.

Symptoms hyperprolactinemia

Occasionally, hyperprolactinemia due to benign tumors such as pituitary adenomas may also occur, among these pituitary tumors, prolactinomas are the most common type representing 30%.



symptom

It is not necessary to produce all the symptoms described below, in some patients only the most common are found:

  • Galactorrhea, milk secretion by the mammary glands, in 30% of cases.
  • Primary or secondary amenorrhea, disappearance of menstruation.
  • Headaches and alterations of the visual field, due to tumoral causes.
  • Hirsutism, if there is a hyperandrogenism.
  • Osteroporosis, if there is a hypogonadism.
  • Decrease in libido
  • Infertility

contraceptive methods in Tarragona(Spain)

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