High Prolactin Levels

Prolactin is one of the hormones secreted by the pituitary gland, a gland at the base of the brain. It is the hormone that results in breast enlargement and helps produce milk when a woman is lactating. Usually, there are low levels of prolactin in the blood of both men and women. Prolactin concentration is controlled by prolactin inhibiting factors, including dopamine. High prolactin levels can block the formation of other hormones in the body, including progesterone and estrogen, leading to health problems. This article will tell you what you need to know about high prolactin levels.

Why Do You Have High Prolactin Levels?

1. Prolactinoma

A prolactinoma is a tumor in the pituitary gland that secretes prolactin. This results in high prolactin levels and a reduction in other hormones secreted by the pituitary gland if it crowds out the other tissues of the pituitary gland.

2. Prescription Drugs

Certain prescription drugs can increase prolactin levels. Drugs that block dopamine, for example, will cause a rise in prolactin levels. Typical drugs that can cause high prolactin levels include Stelazine and Haldol (major tranquilizers), Reglan (often used to treat acid reflux and nausea from cancer drugs), and alpha methyldopa and reserpine (anti-hypertensive medications). If you are taking any of these drugs, talk to your doctor about the effects of these drugs on you.

3. Other Causes

  • Other pituitary tumors: There can be other types of tumors that inhibit the outflow of dopamine from the brain. These mixed-type tumors can occur within or around the pituitary gland and include tumors that secrete growth hormone (such as acromegaly) or those that cause an increase in cortisol (such as Cushing's disease). These can result in high prolactin levels, too.
  • Some nonpituitary tumors: Some cancers like lung cancer can produce prolactin as part of their pathology.
  • Hypothyroidism: People with hypothyroidism can have high prolactin levels. This is why doctors check the thyroid gland hormone levels in people diagnosed with elevated prolactin levels.
  • Breast stimulation: Any time the breasts are stimulated, the prolactin levels will rise, at least temporarily.
  • Chest wall trauma: Injury, such as a trauma from a car accident that damages the chest wall, can cause temporary elevations in the level of prolactin in the bloodstream.
  • Marijuana: Smoking marijuana can cause elevations in the prolactin level in the blood. It goes away once you stop smoking marijuana.
  • Pregnancy also causes elevated prolactin levels. This is a normal physiological response to pregnancy and prepares the breasts to produce milk for the baby.

What Sufferings Will High Prolactin Levels Cause?

High prolactin levels can result in infertility in both men and women who have it. It also results in loss of bone and a decrease in libido.

Women who have elevated prolactin levels will also experience:

  • No symptom at all
  • A lack of periods or irregular periods
  • Dryness of the vagina, leading to pain while having intercourse
  • Excessive production of breast milk even when you are not nursing or pregnant.

Men who have elevated prolactin levels will also experience:

  • Enlargement of the breasts, also known as gynecomastia
  • Erectile dysfunction
  • A decrease in body hair and in muscle mass
  • Decreased sperm or no sperm at all in the ejaculate

How to Diagnose High Prolactin Levels

Usually a simple blood test can show elevated prolactin levels. If the prolactin levels are too high, other tests are done, such as tests for decreased thyroid hormone levels. If the thyroid hormone levels are normal and a discussion of medication use reveals no cause for the hyperprolactinemia, pregnancy is ruled out.

If a prolactinoma is considered to be the cause of high prolactin levels, doctors will do an MRI scan of the brain to visualize the pituitary gland, looking for a tumor of the pituitary gland. The MRI is good at revealing soft tissue abnormalities, including the tissues of the pituitary gland.

How to Deal With High Prolactin Levels

1. Sometimes No Treatment Is Needed

In some cases, the doctors simply watch the elevated prolactin levels and provide no treatment. Having elevated prolactin levels without symptoms usually is not harmful and the doctors can wait and treat the condition only if there are worrisome symptoms. Women can still take birth control pills to provide them with estrogen and to bring about regular menstrual periods.

2. Medication

There are medications to treat high prolactin levels, especially if there are symptoms the person wants to get rid of. These include:

  • Cabergoline is a medication taken twice weekly. The doctor will start at a low dose and increase the dose until the prolactin levels are normalized. The medication is taken until there are no symptoms or until you become pregnant (if that is what you are hoping for). Cabergoline lowers the prolactin levels faster than in those who take bromocriptine, but it can cause problems with the heart valves if taken in doses that are too high.
  • Bromocriptine is taken by some people with elevated prolactin levels. It helps to increase the dose gradually and can be used as a suppository given in the vagina. Side effects include headache, nausea and lightheadedness.

If the medication you are taking is causing the problem of hyperprolactinemia, the doctor may stop the medication and try a different one that does not raise prolactin levels or may add a medication to lower the levels of prolactin.

3. Surgery

If you have a large prolactinoma or if medications are unsuccessful, surgery may be necessary to remove the tumor. There are two types of surgery indicated:

  • Transsphenoidal surgery is the most common approach to the pituitary gland. In such cases, the tumor is accessed and removed through the nose. There is a low complication rate because during this surgery the brain is untouched and no scar is left.
  • Transcranial surgery is recommended if the tumor is big or has spread to the brain. During the surgery, you have a craniotomy and the tumor is reached by means of the skull. 
 
 
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