What Happens When Prolactin Levels are High
Prolactin is a hormone involved in the regular development of the mammary glands and breast milk production. It is secreted by the pituitary gland, a small endocrine gland located at the base of the skull. The hormone’s concentration increases typically in some situations, such as pregnancy and breastfeeding.
Hyperprolactinemia, or increased levels of prolactin in the blood, is a relatively frequent condition in young women with alterations in the menstrual cycle. It can be treated effectively but, when left untreated, has a negative influence on fertility and quality of life.
What are the Causes of Hyperprolactinemia?
The increase in hormone concentrations can be supported by pituitary pathologies and mainly by prolactinoma, a benign tumor affecting the gland that, however, does not represent the most frequent cause of hyperprolactinemia.
Some pathologies, such as polycystic ovary syndrome, hypothyroidism, and chronic kidney disease, can be associated with hyperprolactinemia. It should be remembered and stressed that even taking drugs, such as those used for the treatment of gastrointestinal disorders or nausea, for the management of psychiatric pathologies and the contraceptive pill can induce a picture of hyperprolactinemia. A modest increase in prolactin concentrations may ultimately be caused by the stress induced by blood sampling.
Consequences of High Prolactin Levels
Hyperprolactinemia causes various alterations in reproductive function, up to the lack of ovulation in women. The hypothalamic-pituitary-ovarian axis is sensitive to even slight elevations in circulating prolactin levels. An altered secretion of prolactin is very frequently associated with amenorrhea (lack of menstruation) or other menstrual disorders. It is estimated that approximately 15-30% of secondary amenorrhea, i.e., not due to ovarian disorders, is due to hyperprolactinemia.
Hyperprolactinemia: how is the diagnosis made?
Hyperprolactinemia is diagnosed by evaluating the levels of the hormone in the blood. If blood tests indicate increased prolactin concentrations, the specialist excludes a condition associated with drug therapy and prescribes other in-depth diagnostic tests. To proceed with treatment, it is necessary to establish the cause of hyperprolactinemia.
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How to treat hyperprolactinemia?
If hyperprolactinemia is asymptomatic and does not cause hormonal dysfunction, it is not necessary to resort to specific treatment.
In the presence of prolactinoma, however, we proceed with pharmacological therapy based on dopamine agonist drugs. Some selected cases, mainly if supported by large adenomas or if not responsive to medical treatment, require surgery to remove the tumor.
