Prolactin is a hormone produced by the anterior pituitary gland in the brain. Its main function is to stimulate milk production during breastfeeding.. However, prolactin can also have an impact on fertility both in men as in women.
High levels of prolactin, hyperprolactinemia
In the womenHigh levels of prolactin in the blood, known as hyperprolactinemia, can interfere with ovulation and menstruation, which can make conception difficult. The hyperprolactinemia in women It can be caused by various reasons, such as benign tumors in the pituitary gland (adenomas prolactinomas), medications that increase prolactin production, diseases of the thyroid gland, or certain medical conditions.
In the men, Elevated prolactin levels can also have a negative impact on fertility. The hyperprolactinemia in men It can cause decreased sperm production and erectile dysfunction. Common causes of hyperprolactinemia in men include prolactinoma adenomas and the use of certain medications.
If hyperprolactinemia is suspected and you are having difficulty conceiving, it is important to consult a fertility doctor or reproductive endocrinology. Your doctor may order blood tests to measure prolactin levels and determine the underlying cause. Depending on the cause, treatment may involve correcting an underlying disease, changes in medication, drug therapy to reduce prolactin levels, or, in more severe cases, surgery to remove a tumor in the pituitary gland.
It is important to keep in mind that infertility can have multiple causes, and hyperprolactinemia is just one of them. It is essential to seek specialized medical care to obtain an accurate diagnosis and an appropriate treatment plan.
Normal and altered values of the hormone prolactin
Normal blood prolactin levels They may vary slightly depending on the laboratory perform testing, but in general, normal prolactin values in non-pregnant women are generally considered to be in the range of approximately 2 to 29 ng/mL (nanograms per milliliter).
When a woman is trying to conceive and elevated prolactin levels above normal values are found, this can affect fertility. Elevated prolactin levels can interfere with ovulation and, consequently, make pregnancy difficult.
In general, Prolactin levels above 30 ng/mL are considered elevated and may require evaluation and treatment, especially if a woman is experiencing difficulty conceiving. However, it is important to remember that specific reference values may vary depending on the laboratory and individual patient circumstances.
How is hyperprolactinemia cured?
Treatment of hyperprolactinemia, that is, elevated levels of prolactin in the blood, depends on the underlying cause. Here I mention some of the most common treatment options:
- Changes in lifestyle: If hyperprolactinemia is mild and is due to factors such as stress, excessive exercise, or lack of sleep, making lifestyle changes can help normalize prolactin levels. This may include reducing stress, improving sleep quality, and moderating intense physical activity.
- Medication modifications: If hyperprolactinemia is caused by the use of certain medications, the doctor may consider adjusting the dose or switching to an alternative medication that does not have this side effect.
- Pharmacotherapy: Most of the time, the main treatment for hyperprolactinemia involves the use of medications called dopamine agonists. These medications act on the central nervous system to reduce prolactin production. Examples of dopamine agonists include bromocriptine and cabergoline. Treatment with these medications is usually effective and can help normalize prolactin levels.
- Surgery: In rare cases where hyperprolactinemia is caused by a tumor in the pituitary gland (adenoma prolactinoma) that does not respond well to medications, surgery may be necessary to remove the tumor. This surgery is called transsphenoidal adenomectomy and is performed through the nose and sphenoid sinus.
- Radiotherapy: In extremely rare cases where prolactinoma tumors are resistant to both medications and surgery, radiation therapy may be a treatment option, although it is considered less common.
Specific treatment will depend on the cause of hyperprolactinemia, the severity of symptoms, and the individual's response to treatment. It is important that anyone with hyperprolactinemia be evaluated and treated by a specialist, as these professionals can design an appropriate treatment plan and follow up to ensure that prolactin levels are normalized and reproductive health is restored if necessary.
