Prolactin … what every woman needs to know
Prolactin is a gentle and capricious hormone that is synthesized in a special small part of the brain – the pituitary gland. Its level does not depend on the phase of a woman’s menstrual cycle, although many think that it should be taken on day 2-5 of the cycle, but it depends on many factors and events that occurred in the patient’s life 24 hours before taking blood for this hormone.
Therefore, the day before taking the blood for analysis, it is recommended to exclude the following factors that can lead to increased prolactin levels: sex, gynecological ultrasound, breast ultrasound, irritation of the nipple area, visiting baths, saunas, gyms, excessive exercise, stress – of course, that you do not plan the stress in advance, but if it has already happened – do not take the test the next morning. In addition, our prolactin increases when we sleep, so when you wake up, you do not need to go to the laboratory immediately – wake up 1.5 – 2 hours before the analysis. At the same time it is necessary to remain in a condition on an empty stomach, it is allowed to make only some sips of usual water.
Prolactin levels for women: 4.79-23.3.
Pregnancy: I trimester: 23.5-94.0; II trimester: 94.0-282.0; III trimester: 188.0-470.0.
But why and when to study the level of prolactin?
Hyperprolactinemia is an increased concentration of prolactin in the blood. As a rule, at first a woman does not know that she has an excess of this hormone, but indirectly this condition can be indicated by the following symptoms:
- Menstrual irregularities.
- Menstruation can be scanty, quite rare.
- Decreased sexual desire.
- Of course, work, heavy exercise, chronic insomnia can also reduce sex drive, but if all these factors are eliminated, and the problem remains, you should suspect hyperprolactinemia.
- Growth of mammary glands with the formation of cysts, mastopathy.
- Osteoporosis (increased fragility, brittle bones) with long-standing hyperprolactinemia.
- Dryness of the vagina, decreased hair growth of the genitals.
Clinical symptoms of hyperprolactinemia
- Increased levels of prolactin in the blood (hyperprolactinemia).
- Isolation of milk from the mammary glands (galactorrhea).
- Violation of the menstrual cycle.
What to do next?
- First, if you detect any of the above symptoms, you should consult a gynecologist.
- Second, don’t panic. Due to the development of modern medicine today, in many cases, hyperprolactinemia is treated quite successfully.
- Third, be sure to undergo a complete examination prescribed by a doctor.
- Examine the patient, palpation of the mammary glands. The gynecological anamnesis (a menstrual cycle, date of the last menstruation, existence of amenorrhea, infertility and so on) is estimated. Pregnancy is excluded.
- Liver and kidney function is assessed to rule out liver or kidney failure, in particular, a biochemical blood test is prescribed.
- A blood test for prolactin is performed, if necessary, repeated tests are prescribed. It should be remembered that a number of drugs (estrogens, tricyclic antidepressants, opiates, amphetamines, antihypertensive drugs (reserpine, verapamil, methyldopa), antiemetics, anticonvulsants, anesthetics, antihistamines, cholinergic antagonists, receptor agonists, blockers) increase the concentration of prolactin in plasma, so their appointment is canceled no later than 72 hours. In half of women with galactorrhea, prolactin levels are normal. This is due to the periodic, transient increase in the level of this hormone. Therefore, repeated tests for prolactin are recommended.
One third of women with galactorrhea have no menstrual irregularities.
- In the presence of galactorrhea in combination with the absence of menstruation in 1/3 of cases the cause is pituitary adenoma. If pituitary adenoma is suspected, an consultation with an ophthalmologist (determination of fields of vision) and a neurologist is prescribed. Radiography of the Turkish saddle is performed.
- The most informative method of diagnosing pituitary adenoma is magnetic resonance imaging (MRI).
- Additionally, an ultrasound examination of the abdominal cavity and pelvis (liver, kidneys, ovaries), determination of estrogen, TSH, thyroid hormones can be performed.
- Fourth, regularly take medications prescribed by a doctor and along with the level of prolactin, a woman normalizes her peace of mind.