Hyper hormone prolactin is an increased content of prolactin (one of the most important hormones of the pituitary gland) in the blood serum.
The role of prolactin in the regulation of the female reproductive system:
Among the variety of reasons leading to a violation of the full function of the ovaries and, as a result, endocrine infertility due to the lack of ovulation, the phenomenon of hyper_prolactinemia occupies a special place.
Hormone Prolactin is a unique hormone with over three hundred different biological effects. The main site of prolactin synthesis is the adenohypophysis, one of the most powerful organs for regulating the function of the endocrine glands, located in the brain. It is interesting to note that in addition to the pituitary gland, prolactin can be synthesized in other organs: in the mammary and lacrimal glands, myometrium (uterine muscles), spleen, skin, lymph nodes, and bone marrow. The receptors that receive its signal are scattered practically throughout the body, including the organs of the immune system. The spectrum of action of prolactin is wider than in total for all other pituitary hormones.
The effect of hormone prolactin on the organs of the reproductive system is manifested at almost all levels of regulation. So, even during puberty, prolactin provides the processes of growth and structural development of the mammary gland. In the ovaries, thanks to prolactin, the processes of follicle maturation and ovulation are synchronized. In the uterus, prolactin increases the number of receptors for progesterone and estrogen and has a beneficial effect on the process of embryo implantation.
Thus, it is impossible to underestimate the importance of prolactin in the regulation of the reproductive system. However, the main role of this unique hormone – stimulation of milk synthesis by the glandular tissue of the mammary glands, manifests itself after childbirth, when there is a physiological increase in the level of prolactin in the blood.
Thus, if for a number of reasons (trauma and neoplasms in the brain, taking certain medications, lactation period, stress, etc.) the level of prolactin in the blood serum exceeds physiological values, then this has an extremely negative effect on reproductive function. This phenomenon has been known since the time of Hippocrates. In his famous treatises, he noted: “… if a non-pregnant woman lactates, then her menstruation stops …”.
It should be noted that a reduced function of the thyroid gland (hypothyroidism) can also be accompanied by an increase in the level of prolactin thyroliberin in increased amounts stimulates the synthesis of thyroid-stimulating hormone and prolactin due to a cross effect), therefore it is extremely important, for various disorders of the menstrual cycle, along with prolactin, to determine and serum thyroid-stimulating hormone (TSH) level.
An increase in prolactin levels may be primary when the cause is an increased function of autotrophs (cells in the pituitary gland that produce prolactin) or an increase in their number, which happens with pituitary tumors (prolactin). There are also secondary forms of hyper_prolactinemia associated with various diseases and neoplasms in the brain, taking medications that indirectly stimulate the formation of prolactin (oral contraceptives, cervical, methyl dopa, haloperidol, etc.).
When should you think about possible violations of hormone prolactin synthesis?
First of all, with an irregular menstrual cycle. Most often, an increase in the level of prolactin in the blood provokes delays, and in more severe cases, the complete cessation of menstruation. In addition, if a woman develops discharge from the mammary glands in the form of colostrum, aggravated by pressure, or lactorrhea (spontaneous milk release), you should urgently consult a specialist. The minimum list of examinations should include determination of the content of prolactin and TSH in the blood, ultrasound (in women under 35 years of age), or X-ray examination of the mammary glands.
It should be noted that even if a woman has maintained the rhythm of menstruation, and pregnancy does not occur, it is necessary, first of all, to determine the content of prolactin in the blood serum.
Depending on the level of prolactin, the doctor decides on the advisability of conducting an MRI of the brain, in order to exclude the hormonally active tumor of the pituitary gland – prolactinomia. As a rule, micro (up to 1 cm) and micro_prolactinomas (more than 1 cm) are accompanied by a significant increase in the content of prolactin in the blood (over 1500-2000 miu / L). Less significant increases may indicate functional hyper_prolactinemia.
In this regard, it is very important to conduct at least three studies of the hormone with an interval of several days and preferably at the same time.
If the diagnosis of hyperprolactinemia is confirmed, then before planning a pregnancy, it is necessary to conduct a course of drug therapy aimed at normalizing the level of prolactin. The duration of the therapeutic effect is always individual, but, as a rule, 3-6 months of stable compensation is sufficient. If the increase in prolactin is due to a pituitary adenoma, then the need for specific therapy remains during both the period of preparation for pregnancy and the entire period of gestation and lactation.
Finally, it should be noted the presence of the phenomenon of “Macro Prolactinemia” in clinical practice. This is an exclusive laboratory phenomenon, due to the fact that increased biters of prolactin are determined in the patient’s blood, and any clinical symptoms are completely absent. This phenomenon can be caused by the fact that the increase in the hormone level is due to biologically low active “big” and “big-big” prolactin hormone with a high molecular weight. In this case, you do not need to take any medications.
The hormone Prolactin has a fairly pronounced circadian rhythm, with the maximum release of the hormone during a night’s sleep. Therefore, blood is taken for analysis in the morning, not earlier than 3 hours after waking up. The normative values of prolactin hormone in the blood serum in women range from 67 to 726 miu / L;
Before conducting the study, it is necessary: 1 day to exclude sexual intercourse and heat effects (sauna), 1 hour – smoking. Because the level of prolactin is greatly influenced by stressful situations, it is desirable to exclude factors influencing the research results: physical stress (running, climbing stairs), emotional arousal, sleepless night, etc.