The blood of women and men contains identical hormones, but in different concentrations. Prolactin is produced in the anterior pituitary gland. He, like everyone else, is present in the body of both sexes, but in small concentrations. And its excess content in the blood causes a condition called hyperprolactinemia. What is hyperprolactinemia syndrome, what are the causes of its development, and what drugs are used to treat it?

The level of prolactin in the blood can rise for several reasons. Hyperprolactinemia in men and women is divided into three groups:

• physiological;
• pathological;
• pharmacological.

Physiological hyperprolactinemia

The main drugs for stabilizing the hormonal background in hyperprolactinemia are preparations based on ergot alkaloids, for example, Bromkriptin. This drug activates the production of dopamine, which, in turn, blocks the synthesis of prolactin.

If a woman is diagnosed with hyperprolactinemia and pregnancy occurs, in the process of bearing a baby, she is also prescribed Bromocriptine. However, this drug is not contraindicated in lactating women. If necessary, they are prescribed treatment with ergot alkaloids without giving up breastfeeding. Conducted studies have shown that they do not harm either the child or the young mother.

In addition to Bromocriptine, other drugs may be prescribed:

• Lisuride;
• Tergurid;
• Cabergoline;
• Metergolin;
• Dihydroergocriptine.

If any pathology of the internal organs has become the cause of the development of hyperprolactinemia, then the underlying disease is treated.

Folk remedies

An increase in the level of prolactin in the blood is often a signal of the presence of serious pathologies that are difficult to treat with medication. Therefore, folk remedies can be used as an additional way to eliminate the symptoms of the disease.

Prolactin is a stress hormone, so during the treatment period it is necessary to take herbal infusions that help relieve nervous tension and normalize sleep. In this case, it is useful to take fees based on motherwort, valerian and lemon balm. Hawthorn, St. John's wort, black elderberry, passion flower and hop cones contribute to the normalization of the emotional state.

Other factors to consider include:

• alternation of work and rest;
• exclusion of stressful situations;
• compliance with the sleep regimen;
• exclusion of alcohol and nicotine;
• refusal of coffee and black tea.

If treatment with medications has not brought positive results, or tumor growth or visual impairment has begun to progress, the patient undergoes surgical intervention. However, its disadvantage is the lack of guarantee in the development of relapses of the disease.

During the operation, the affected tissue is removed and accessed through the sinuses. Given the complexity of the surgical intervention and the risk of complications in the form of damage to the carotid artery, the development of meningitis and paralysis of the optic nerve, it should be carried out in a specialized hospital by experienced surgeons.

If a decision is made to perform an operation, treatment with medications is stopped, as they lead to a thickening of the tissue, which significantly complicates the process of surgical treatment.

The operation is considered successful if the level of prolactin stabilizes after 2 hours, and ovulation occurs 40 days after the end of the operation.

Complications arising from hyperprolactinemia

Delay in seeking medical help can lead to the development of complications, expressed in the following:

• insufficiency of the functions of the pituitary gland and thyroid gland, requiring the use of hormonal therapy;
• a sharp decrease or complete loss of vision caused by a growing tumor;
• fragility of bones;
• degeneration of a benign pituitary tumor into a malignant one.

Prevention methods

With hyperprolactinemia, no preventive measures are taken. Upon completion of treatment, patients do not require rehabilitation. No rules are established in the principle of nutrition. The only factors that require exclusion from everyday life are stress.

Women who have undergone treatment and do not plan to have children in the future should carefully consider the choice of contraceptives. The most popular estrogen-containing contraceptives should not be used, as they increase prolactin levels. The use of intrauterine devices is also contraindicated, since they, due to the effect on the endometrium, have a similar effect.

The only ways to avoid unwanted pregnancy are oral contraceptives containing progestogen, as well as laparoscopic sterilization.

Features of hyperprolactinemia in men

Despite the fact that this disease is diagnosed in a strong half of humanity much less frequently than in women, it is most often caused by pituitary macroadenomas.

Most often, the disease manifests itself in a decrease in sexual desire. If a man pays attention to his condition in time and manages to come to the doctor, he may be able to avoid impotence. However, the development of impotence is most often associated with psychogenic factors. The true cause can be established after examining the patient, which reveals softening of the testicles and swelling in the chest area.

In men, the disease is diagnosed in the same way as in women. In this case, only the physiological characteristics of the patient are taken into account.

Prognosis for hyperprolactinemia

Modern methods of diagnosis and treatment in most cases can achieve positive results. People who have undergone treatment are able to lead a normal life while maintaining reproductive function.

In the presence of pituitary prolactinoma, a doctor's observation is indicated, which allows timely detection of relapses of the disease. For this reason, an MRI and an oculist consultation are required once a year. Also, twice a year, it is required to appear for a blood test that controls the level of prolactin.

Bibliography

1. New honey. technology (Methodological recommendations) "Management of preterm pregnancy complicated by premature rupture of membranes"; Makarov O.V., Kozlov P.V. (Edited by Volodin N.N.) - RASPM; Moscow; TsKMS GOU VPO RSMU-2006.
2. Non-developing pregnancy. Radzinsky V.E., Dimitrova V.I., Mayskova I.Yu. 2009 Publisher: Geotar-Media.
3. Baskakov V.P., Tsvelev Yu.V., Kira E.F. endometrial disease. - St. Petersburg,
4. Miscarriage, infection, innate immunity; Makarov O.V., Bakhareva I.V. (Gankovskaya L.V., Gankovskaya O.A., Kovalchuk L.V.) - "GEOTAR - Media". - Moscow. - 73 p.-2007.

She graduated from the Kirov State Medical Academy in 2006. In 2007, she worked at the Tikhvin Central District Hospital on the basis of the therapeutic department. From 2007 to 2008, he worked at a hospital for a mining company in the Republic of Guinea (West Africa). From 2009 to the present, he has been working in the field of information marketing of medical services. We work with many popular portals, such as Sterilno.net, Med.ru, website

Hello everyone, this is Olga Ryshkova. Why does the prolactin hormone increase? What is it - hyperprolactinemia syndrome in women and men? We will discuss this today. Prolactin is a hormone, that is, it belongs to the endocrine system. Prolactin is produced by the pituitary gland, the main endocrine gland, which is located in the brain. The purpose of prolactin is the production of milk by the mammary glands. The mammary glands of both women and men respond to the action of prolactin.

Hyperprolactinemia is an increase in the level of prolactin in the blood. Hyperprolactinemia can be a normal phenomenon and then it is called physiological, or it can be a consequence of a disease and then it is called pathological.

When does physiological hyperprolactinemia occur?

It can be in women in the second half of the menstrual cycle. The body never knows how the menstrual cycle will end and always tunes in to a future pregnancy. The body of a woman in the second phase of the cycle always tunes in to pregnancy and therefore prolactin rises.

The level of prolactin in a woman also rises during pregnancy and during lactation, that is, when she feeds her baby. This hyperprolactinemia is a physiologically normal condition.

And when?

Prolactin also rises in both women and men during stress, during heavy physical exertion, with an abundant intake of protein foods and after sexual intercourse. I want to say that if your prolactin level is slightly elevated, literally a few units above the norm, and it worries you, and you don’t know what to do with it, then it is recommended to measure this indicator several times in a calm state. Not when you left the gym, after physical activity with protein foods, not after sexual intercourse, not after stress, not at the exit from the disease, after a respiratory viral infection, but in a calm state in the morning on an empty stomach, come several times and donate blood for prolactin.

Pathological hyperprolactinemia.

Now about the pathological increase in prolactin in the blood or pathological hyperprolactinemia. The main causes associated with the pituitary gland are pituitary tumors, adenomas, traumatic lesions of the pituitary gland and lesions associated with vascular disorders in the brain, such as heart attacks. But these are rare causes of hyperprolactinemia in both women and men. As a rule, they are accompanied by other clinical symptoms that are visible and indicative to the doctor, and the doctor will quickly differentiate such pathologies and send such a patient to the destination.

More pathological reasons.

And also when prolactin rises, when we don’t even think that it can be elevated? The first and very important is kidney and liver failure, especially liver failure in alcoholic cirrhosis. That is, if you do not protect your body and your prolactin rises, then these are links in the same chain.

Hormonal causes of hyperprolactinemia.

The next moment is hormonal. In women, it is polycystic ovary syndrome (PCOS). With PCOS, the disorder of the pituitary-ovarian system is such that prolactin rises.

In men, this is chronic prostatitis, this is a proven cause of an increase in prolactin.

Idiopathic hyperprolactinemia.

There is also such a thing as idiopathic hyperprolactinemia. Such a diagnosis is made when everything is in order with the head, that is, no structural pathological changes were found in the endocrine part of the brain, they do not cause an increase in prolactin. Nevertheless, prolactin rises and then this diagnosis is made. "Idiopathic" in translation from medical to universal means "it is not known for what reason."

Why does prolactin rise?

And even after taking potent substances, which include all antidepressants, because they affect dopamine receptors, and the blockade of dopamine receptors is the cause of an increase in prolactin.

The next point is antihypertensive therapy, that is, patients with a high risk of arterial hypertension who constantly take drugs that reduce blood pressure are at risk of increasing prolactin.

This also includes opiates and centrally acting antiemetics and, most interestingly, estrogens. Women who take estrogens as prescribed by a gynecologist or endocrinologist, which is associated with some specific gynecological condition, are at risk for increased prolactin.

Men who incorrectly exit anabolic steroid therapy for muscle building are also at risk for hyperprolactinemia. They also have increased estrogen in the blood and this leads to an increase in prolactin. That is, in both men and women, in addition to disorders associated with the hormonal part of the brain, there are a lot of reasons for increased prolactin in the blood.

What are the symptoms of hyperprolactinemia?

The symptoms of hyperprolactinemia are as follows. In men, it will be gynecomastia. Who does not know what gynecomastia is - a swelling of the mammary glands in men, that is, such an anatomical defect visible to the eye. There was an even body and suddenly a semblance of such female mammary glands. There is also a decrease in sexual function and a decrease in fertility, that is, infertility, since prolactin affects the formation of spermatozoa in men (spermatogenesis) and increased prolactin reduces the properties of sperm in such a way that a man becomes infertile.

In women, the range of disorders is much wider. This is a shortening of the second phase of the menstrual cycle, up to complete amenorrhea (cessation of the menstrual function in general). If the menstrual function is maintained, then most menstrual cycles become anovulatory, that is, ovulation is suppressed and the woman suffers from infertility.

Infertility is the primary complaint in hyperprolactinemia in both men and women. And I’ll tell you even more, it is believed that every third woman and every sixth man suffers from infertility due to hyperprolactinemia. That is, somewhere around 30% of women and 15% of men suffering from infertility need therapy that lowers prolactin.

Another symptom of hyperprolactinemia.

And another symptom is galactorrhea, that is, the flow of milk from the mammary glands. This can be both in women and in men with severe hyperprolactinemia.

What else?

In women and men, it can be osteoporosis, depression, sleep disturbance. Well, the symptoms associated with central causes, when there are tumor disorders in the pituitary gland, then there may be a narrowing of the visual fields, headaches and other symptoms associated with a tumor in the pituitary gland.

What to do?

Therefore, if you have been diagnosed with an increase in prolactin in the blood, you should not despair, but take the test several times again. If you are a woman, then you do this on the 3rd-5th day of the menstrual cycle for about 3 months. In the morning on an empty stomach for 3-4-5 days, the level of prolactin is measured in a calm state. And if all 3 times you see a persistent increase in prolactin, consult a doctor.

If you are a man, then you also choose a time when you are not after stress, not after physical exertion and measure the level of prolactin several times. If the level of prolactin is persistently elevated, then you should see a doctor.

Which doctor?

To the endocrinologist. What will the endocrinologist tell you? Be sure to undergo an MRI of the brain in order to exclude a tumor or adenoma of the pituitary gland. And if neither a tumor nor an adenoma is found there, then the doctor will prescribe you drugs that affect dopamine receptors and reduce the level of prolactin in the blood.

This is the main therapy of choice for hyperprolactinemia - the appointment of such drugs.

What to do if the drugs do not help?

They are prescribed surgical correction or radiation correction. Treatment methods for hyperprolactinemia have been developed.

Last question.

And the last question - how much should you take prolactin-regulating drugs? If you are a man, then you take the course prescribed by the doctor, then laboratory control, then, if necessary, again a course of correction.

If you are a woman and you are treating infertility, then you take prolactin-lowering drugs until the moment of pregnancy. This should not be - you drank three months and that's enough. You drink the drug until the desired pregnancy occurs. Then you go to the doctor, the doctor declares pregnancy and cancels the drug for you with his own hand. In no case do you cancel the treatment of hyperprolactinemia yourself, because you are pregnant and because all medicines are harmful to your child. The doctor prescribed the drug, the doctor cancels it.

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The most common reason for women to visit a gynecologist is menstrual irregularity and the inability to conceive a child. However, this factor is often caused by diseases of the endocrine system. Hyperprolactinemia in women is one of the conditions that lead to the absence of ovulation, and as a result, to infertility.

This condition is not a disease, but a syndrome that manifests itself with many signs characteristic of other diseases. The syndrome of hyperprolactinemia is characterized by an increased content of the hormone prolactin in the blood. It can also develop in men, although much less frequently than in the representatives of the beautiful half of humanity.

To avoid serious health problems, it is necessary to identify the problem as early as possible and begin its treatment. And for this you need to know about the main manifestations of the disease and about what causes lead to its development.

Brief information about prolactin

The production of the hormone is carried out by the anterior pituitary gland, and its main target organ is the mammary glands. Prolactin, otherwise called lactogenic, luteotropic or mammotropic hormone or mammotropin, is a protein and is necessary for the implementation of lactation.

During puberty, prolactin is responsible for the growth and development of the mammary glands. With the onset of pregnancy, its functions include an increase in the number of lobules and ducts. In the future, it contributes to the production of colostrum and its conversion into milk.

During the study of this substance, it was found that prolactin receptors are present in almost every organ of the human body. However, its effect on other internal organs has not been studied enough.

The concentration of the hormone in the blood is prone to daily fluctuations. Its highest level is observed in the morning immediately after waking up. Within a few hours, the concentration of prolactin decreases. At the same time, its level is under the tireless supervision of another hormone -.

Norm of prolactin

The functions of prolactin, one way or another, are associated with the reproduction of offspring. Normally, the levels of the hormone in the blood should correspond to the following parameters:

• from 252 to 419 mIU / l - for women of childbearing age;
• up to 390 mIU / l - for women in menopause;
• up to 380 mIU / l - for men.

Effect on the thyroid gland

By acting on the thyroid gland, prolactin reduces the production of calcitonin, which contributes to an increase in the calcium content in breast milk. However, excessive production of mammotropic hormone reduces the formation of new bone tissue, which leads to the development of osteoporosis in women. It should be noted that hyperprolactinemia in men very rarely manifests itself in a decrease in bone density.

Impact on the immune system

Scientists have also proven the effect of prolactin on the immune system. In their opinion, this hormone inhibits the activity of its cells, preventing the rejection of the fetal egg during pregnancy. Meanwhile, at other times, this property of prolactin negatively affects human health. People suffering from hyperprolactinemia are susceptible to attack by viruses and infections.

Causes of the development of hyperprolactinemia syndrome

There are several forms of hyperprolactinemia:

• transient;
• idiopathic;
• pathological.

Features of the transitory form

Physiological processes contribute to the development of a transient form of hyperprolactinemia. These include:

• sexual intercourse;
• food intake;
• lack of sleep.

As mentioned above, during intercourse there is an increase in the production of prolactin. However, the increase in its concentration in the blood, as a rule, is insignificant and persists for a short time.

Increase the concentration of the hormone and some foods. However, in this case, this condition is the norm. Insufficient night sleep leads to a violation of the cyclical production of the hormone. Therefore, it is very important to sleep at night, not trying to compensate for a night's rest with daytime sleep.

Hyperprolactinemia does not require specific treatment in these cases. If the level of the hormone rises due to lack of sleep, it is necessary to adjust the mode of work and rest.

Features of the idiopathic form

The idiopathic form of hyperprolactinemia is diagnosed if the cause of the increase in the concentration of prolactin could not be established. In this case, there is an increase in the activity of pituitary cells, which actively produce the hormone. Prolactin in this form of hyperprolactinemia syndrome, as a rule, has low biological activity, and its level rises slightly.

Features of the pathological form

With this form of the disease, there is a significant increase in the level of prolactin, accompanied by clinical manifestations of the disease. Prolonged exposure to prolactin on the body leads to disruption of the functions of internal organs.

The pathological form of hyperprolactinemia syndrome can be of two types:

• organic, caused by dysfunction of the pituitary gland;
• functional, the development of which is facilitated by other diseases.

Reasons for the development of organic hyperprolactinemia

Two types of benign neoplasms can form in the pituitary gland:

• - a tumor, the size of which does not exceed 1 cm;
• macroadenoma - a tumor larger than 1 cm.

An adenoma is a benign neoplasm that can either slowly increase in size or not grow at all. consists of active pituitary cells that produce. What kind of hormones an adenoma produces depends on its location. Prolactin is produced by an adenoma in the anterior pituitary gland.

However, organic hyperprolactinemia in men and women can develop not only because of the tumor. Other pathological conditions also contribute to this. These include:

• violation of cerebral circulation, disrupting the nutrition of the pituitary gland;
• malignant neoplasms.

Reasons for the development of functional hyperprolactinemia

The reasons for the development of this form of the disease lie in the violation of the functions of other internal organs. Pathological hyperprolactinemia may occur due to the following pathological conditions:

• hypothyroidism;
• gynecological diseases, which include endometriosis, uterine fibroids, polycystic ovary syndrome;
• infectious processes;
• cirrhosis of the liver;
• frequent stress;
• long-term use of certain pharmaceuticals, which include hormonal contraceptives, and narcotic drugs.

An increase in prolactin levels can also be caused by a mutation in the gene containing the hormone receptor.

Manifestations of hyperprolactinemia

When hyperprolactinemia develops, symptoms differ between men and women. This is not surprising, since in both sexes this hormone performs completely different functions.

Symptoms of hyperprolactinemia in men

In the body of men, prolactin is produced much less than in women of reproductive age. The amount of the hormone becomes approximately the same only with the onset of menopause in women. However, the reasons for the development of this syndrome also differ. If in women it often occurs against the background of gynecological diseases, in men its development is almost always associated with pituitary adenoma.

A prolonged increase in the concentration of prolactin in men leads to the development of the following manifestations:

• decrease in the quality and quantity of seminal fluid;
• breast enlargement;
• galactorrhea - a disease in which colostrum is secreted from the mammary glands;
• decreased attraction to the opposite sex;
• impotence;
• unreasonable weight gain;
• headaches;
• loss of visual fields;
• depressive states.

It should be noted that headaches and loss of visual fields can only be present if there is a macroadenoma in the pituitary gland that compresses the optic and other nerves.

Treatment of hyperprolactinemia syndrome in men is primarily aimed at eliminating the tumor in the pituitary gland.

Symptoms of hyperprolactinemia in women

In women, this pathology is manifested by the following symptoms:

• lack of natural lubrication in the vagina;
• pain that occurs during intercourse;
• decrease in sexual desire;
• lack of orgasm;
• menstrual disorders or amenorrhea;
• inability to conceive a child;
• colostrum secretion not associated with breastfeeding;
• enlargement of the mammary glands;
• the development of a benign neoplasm in the mammary glands;
• loss of visual fields;
• headaches;
• a decrease in bone density with the subsequent development of osteoporosis;
• depressive states;
• an increase in body weight.

Violation of the menstrual cycle and the inability to conceive a child are the most common signs of hyperprolactinemia. If you still managed to get pregnant, the development of various complications is possible.

No specific treatment is prescribed for pregnant women. The reason for this is that hormonal drugs prescribed for hyperprolactinemia can cause spontaneous abortion.

If hyperprolactinemia occurs due to pituitary adenoma, then in this case, treatment during pregnancy is contraindicated. All antitumor drugs designed to suppress the growth of pituitary cells have a toxic effect, which can adversely affect the intrauterine development of the baby.

Diagnostic methods

Violation of the production of prolactin can be seen by characteristic signs. However, before a final diagnosis is made, the patient undergoes a laboratory blood test to determine the concentration of prolactin.

Given the fluctuations in prolactin in the blood of women, they are recommended to take a blood test after 5-8 days from the start of the menstrual cycle. To eliminate the error, blood sampling is carried out several times.

Further diagnosis is to find the cause that contributes to the development of hyperprolactinemia. The list of diagnostic measures includes the following types of studies:

• a blood test that allows you to determine the level of thyroxine and triiodothyronine - hormones produced by the thyroid gland;
• a blood test for the content of thyroid-stimulating hormone produced by the pituitary gland;
• ophthalmological examinations to assess the condition of the fundus and identify visual field loss;
• x-ray of the skull, allowing the study of the Turkish saddle;
• CT scan;
• magnetic resonance imaging.

It should be noted that the last three diagnostic methods are carried out only if the patient has not been found to have other pathologies that can provoke the development of hyperprolactinemia.

How is hyperprolactinemia treated?

Hyperprolactinemia does not always require treatment. It is not prescribed to women with prolactinoma who do not plan to have children in the future. However, if a woman has menstrual irregularities, she is prescribed hormone replacement therapy. In all other cases, treatment is carried out under the supervision of an endocrinologist.

Treatment of hyperprolactinemia is primarily aimed at eliminating the underlying disease. If it is hypothyroidism, hormonal therapy is performed to restore normal levels of thyroid hormones in the blood. This therapy, as a rule, leads to a decrease in the level of prolactin.

Most often, patients undergo conservative treatment aimed at eliminating the cause of the development of hyperprolactinemia syndrome. If this disease was caused by a tumor in the pituitary gland, they are also trying to eliminate it with the help of medications. Surgical intervention is performed only if the patient has a large tumor that is insensitive to the medications used.

The most commonly used drugs are:

• Dostinex, made on the basis of cabergoline;
• Bromocriptine is a semi-synthetic derivative of the ergot alkaloid.

Both of these drugs inhibit the synthesis of prolactin by activating dopamine receptors.

The dosage of drugs and the scheme of their administration are selected by the doctor for each patient individually. Self-medication in this case is unacceptable, since it can lead to an increase in adenoma and its degeneration into a malignant tumor.

As a rule, prolactinomas and mixed adenomas sharply decrease in volume under the influence of pharmaceutical preparations. And the level of prolactin is restored after 2-3 months of drug therapy.

Treatment should be carried out under the supervision of an endocrinologist. At the same time, it is necessary to conduct an annual examination of the pituitary gland and control the level of prolactin in the blood.

Women with pituitary adenoma drug therapy is carried out for two years. Ovulation, as a rule, is restored after six months of treatment. However, pregnancy can be planned only one year after the end of treatment and medication.

Conclusion

Any manifestations of hyperprolactinemia require treatment under the supervision of an experienced specialist. It should be borne in mind that self-treatment of hyperprolactinemia syndrome can lead to tragic consequences, since this disease can develop due to a variety of pathological processes.

There are no preventive measures that can prevent the development of hyperprolactinemia. Both women and men can lead the way of life to which they are accustomed.

Of particular difficulty in women who have undergone treatment for hyperprolactinemia is the choice of contraceptive method. In this case, the use of contraceptives containing estrogens is not allowed, since this hormone increases the concentration of prolactin.

Also, the use of intrauterine devices is not allowed. Although their effect on the development of hyperprolactinemia has not been proven, some experts believe that IUDs increase prolactin by irritating endometrial receptors.

For these reasons, the only methods of contraception are either the use of progestogen-containing contraceptives or laparoscopic sterilization.

Prolactin, together with luteinizing (LH) and follicle-stimulating (FSH) hormones, provides sexual desire and the process of procreation. In women, thanks to them, estrogens are formed, eggs mature, and lactation starts. In men, these hormones are responsible for sperm motility and testosterone production.

As the name implies, hyperprolactinemia is characterized by too much of the hormone prolactin, caused by its overproduction by the pituitary gland. The norm of the content of this hormone is clearly established in men, but for women at various stages of the menstrual cycle, when carrying a child, shortly after it is born and during lactation, the indicators differ. Hyperprolactinemia in children and adolescents is detected in only 5% of cases.

Physiological hyperprolactinemia

In healthy women, under certain circumstances, a blood test can show elevated levels of prolactin. It is caused by a number of physiological factors:

• Increased physical activity
• stressful situations,
• Pregnancy,
• postnatal state,
• Lactation,
• Sexual intercourse.

Pathological hyperprolactinemia

There is an idiopathic form of increased function of the pituitary cells - this is a kind of hyperprolactinemia, in which there are no visible factors that cause an increase in the level of the hormone - the size of the pituitary gland is only slightly larger than normal or not changed at all.

In other cases, there is an organic or functional factor that causes the development of hyperprolactinemia.

Causes

Organic hyperprolactinemia occurs with the appearance of a tumor (benign neoplasm) of the pituitary gland. This structure independently produces prolactin.

• With estrogen content
• from hypertension,
• prostaglandins
• neuroleptic,
• antidepressants,
• Oral contraception.

• cirrhosis of the liver,
• hypothyroidism,
• Polycystic ovaries.

Or it develops as a result of surgical interventions in the chest area, curettage of the uterus.

Symptoms

In males, an excess of prolactin will be manifested in a decrease in sexual desire, impotence and even infertility. These symptoms are associated with a drop in testosterone production.

Females also experience infertility. It occurs against the background of irregularity or lack of ovulation, phase II failure, cycle failure or cessation of menstruation. Milk or colostrum (galactorrhea) may be shed in non-pregnant and nulliparous women.

Diagnostics

The primary way to detect hyperprolactinemia is a laboratory analysis of the patient's blood. It should be given in the morning. For men, as a rule, a two-time procedure is sufficient, with the necessary interval, excluding an increase in prolactin from physiological factors. Women need to donate blood in accordance with the menstrual cycle, from the fifth to the eighth day.

To identify or eliminate the organic cause of the occurrence of hyperprolactinemia allows modern hardware techniques: computer (X-ray) and magnetic resonance imaging. Less accurate and visual results are obtained by the use of craniography (X-ray of the skull in 2 projections).

It is important to know that the amount of prolactin can be increased for physiological reasons, which is easy to identify by analyzing 2-3 times, this is a kind of norm. When confirming pathological hyperprolactinemia, it is required to identify its cause and carry out a correction.

Hyperprolactinemia: ICD-10 code

According to the international classification of diseases, the code for hyperprolactinemia according to ICD-10 is E 22.1

Causes of hyperprolactinemia

Causes of hyperprolactinemia are:

• physiological;
• pharmacological;
• pathological.

Prolactinemia of the physiological type develops due to the activation of prolactin production. This process develops after prolonged sports physical activity, when eating protein-rich foods. To provoke an increase in the production of prolactin can sound sleep, stress or sexual contact.

The use of certain medications negatively affects the metabolism, and increases the amount of prolactin. These medicines include:

• Butirofen;
• Methyldop;
• Decarboxylase;
• Phenothiazine;
• pimozide;
• Reserpine.

If pathologies develop in the female body, the volume of prolactin in the blood also increases, hyperprolactinemia occurs. This happens with the following diseases:

• pituitary adenoma (benign neoplasm);
• tuberculosis;
• sarcoidosis;
• tumors in the hypothalamus;
• gliomas.

The consequence of their development is the cutting of the legs of the pituitary gland. Irradiation helps to cope with the problem, which activates the production of prolactin.

Functional hyperprolactinemia occurs when:

• impaired functioning of the thyroid gland;
• cirrhosis of the liver;
• polycystic ovarian syndrome;
• chronic kidney failure.

The development of prolactinemia is facilitated by frequent operations or permanent injuries of the chest. Pathology appears in women who have undergone curettage of the uterus.

What are the symptoms of hyperprolactinemia?

The pathological condition of the female body called hyperprolactinemia can form a diverse clinical picture. Symptoms of the disease differ depending on the gender of the patient. Sometimes the disease is diagnosed during a random examination, but it happens differently. Signs of hyperprolactinemia in some women are quite well expressed, in the form of disorders at the sexual, reproductive, emotional-personal and metabolic levels.

Signs of hyperprolactinemia in women:

• about 90% of patients diagnosed with hyperprolactinemia suffer from menstrual disorders due to amenorrhea, oligomenorrhea, or opsomenorrhea. Such violations are especially pronounced after stress, the onset of sexual intercourse, abortion, the birth of a child, or the abolition of oral contraceptives;
• frigidity, low sexual activity;
• the presence in the anamnesis of the patient with hyperprolactinemia of frequent abortions that occurred spontaneously in the early periods of pregnancy, as well as infertility that develops against the background of absent ovulation cycles;
• galactorrhea (a pathology in which women who are not nursing mothers ooze milk or colostrum from the nipples), which can be primary (a few drops of milk appear from the nipples when pressing on the chest), secondary (with minimal squeezing of the nipples, milk flows out abundantly, multiple droplets or trickle), tertiary (milk from the nipples expires spontaneously, without any pressure);
• migraine attacks, headaches, dizziness, PMS;
• acne on the surface of the skin of the face and body, activation of hair growth around the nipples, on the face, arms, legs and abdomen;
• swelling, soreness, increased sensitivity of the breast;
• pain in the joints and bones, provoked by a prolonged absence of medical procedures, leaching of calcium from the bones, the occurrence of osteoporosis and looseness of bone tissue;
• insulin resistance, overweight;
• decreased visual acuity and limited viewing angle due to macroprolactinoma (a tumor that compresses the optic nerves);
• moderate recovery of the external genitalia after surgery;
• disorders at the psycho-emotional level, depression, disturbed sleep, pain of unknown origin in the region of the heart, weakness, impaired memory.

The symptoms of hyperprolactinemia in women and the treatment of this pathology depend on how timely the problem is detected. At the slightest sign of pathology, a woman should go to the hospital. Timely therapy will help to avoid serious complications.

Hyperprolactinemia in men, the symptoms of which are much less common than in females, has the following symptoms:

• decreased sexual desire and potency in 50-85% of cases;
• reduction in the severity of secondary sexual characteristics (from 3% to 20%);
• infertility, which develops due to a decrease in sperm quality by 3.5-14% or a decrease in its quantitative indicators;
• hyperprolactinemia galactorrhea (0.5-8% of cases);
• acne and moderate hair growth on the face, in the nipples, on the upper and lower extremities;
• severe migraine attacks, headaches, dizziness;
• deterioration of visual functions, decreased visual acuity, macroprolactinoma;
• insulin resistance, overweight;
• psycho-emotional disorders, subjective symptoms (the appearance of general weakness, memory problems, depression, unexplained pain in the heart);
• an increase in breast tissue (gynecomastia), developing in 6-22% of cases, having 3 stages (proliferating, intermediate and fibrous).

Types of hyperprolactinemia

Varieties of hyperprolactinemia directly depend on the nature of the underlying disease. This pathology can be of the following types:

• physiological;
• idiopathic;
• pathological;
• functional (secondary);
• organic;
• pharmacological (drug).

Each type of hyperprolactinemia proceeds individually, with its own characteristics and nuances.

Physiological or transient hyperprolactinemia has the following mechanism of development. The protein hormone prolactin is produced in the body of every woman and stimulates lactation (the appearance of breast milk after the birth of a child). The process of production of this hormone is controlled by the endocrine glands, hypothalamus and pituitary gland. Sometimes too much prolactin is produced, and this condition is medically referred to as hyperprolactinemia. At the physiological level, this pathology is formed due to the influence of the following adverse factors:

• severe stress;
• excessive physical activity;
• sexual contact;
• oversaturation of the diet with protein foods;
• low blood sugar;
• deep dream.

It should be noted that prolactin is a stress hormone, so it is not surprising that in intense emotional situations, its amount in the blood increases. At the same time, a person experiences severe weakness and may even faint due to a sharp decrease in pressure.

A feature of idiopathic hyperprolactinemia is the absence of obvious causes and pronounced signs of pathology. There is a sudden activation of the activity of the cells of the human body, and the release of large doses of prolactin into the blood. This process is sometimes facilitated by the nervous environment in which the patient has been for a long time. Idiopathic hyperprolactinemia and stress are strongly interconnected with each other. The hormone prolactin, which provokes the development of pathology, is, in fact, stressful. Sometimes the disease occurs together with polycystic ovaries, and idiopathic hyperprolactinemia in men develops against the background of a chronic inflammatory process in the prostate gland. A man complains of a lack of sexual desire and high fatigue when performing complex physical work or exercises.

The development of hyperprolactinemia syndrome in men and women often occurs due to various concomitant diseases. In this case, an increase in the hormone prolactin leads to the development of 2 types of conditions.

1. Organic. Most often, the pathology develops due to prolactinoma (pituitary adenoma). Sometimes the neoplasm has microscopic dimensions (no more than 1 cm). There are other cases when the parameters of adenoma exceed 1 cm. And here doctors are already talking about macroprolactinoma.
2. Secondary hyperprolactinemia (functional) is a condition that occurs against the background of serious diseases (trauma in the chest, cirrhosis of the liver, polycystic ovaries, chronic renal failure, lack of thyroid hormones in the body).

In addition, functional hyperprolactinemia in women is formed due to repeated procedures for curettage of the uterine cavity.

Drug-induced hyperprolactinemia (also called pharmacological) occurs in patients taking medications that lead to metabolic and hormonal disorders. Under the influence of certain drugs, the production of dopamine is disrupted, and the cells of the body can no longer absorb it. If the concentration of this hormone in the blood increases sharply, then the production of prolactin, which is under the control of dopamine, is reduced. Drug or iatrogenic hyperprolactinemia is possible while taking such drugs:

• Butirofen;
• Decarboxylase;
• pimozide;
• Reserpine;
• Methyldol;
• Domperidone.

There are other categories of drugs that increase the amount of prolactin in the blood. They do contain estrogen. They are the reason for the increase in lactogenic hormones and the simultaneous suppression of the synthesis of luteinizing and follicle-stimulating hormones. In such cases, against the background of hyperprolactinemia, infertility often develops.

Diagnosis of hyperprolactinemia

To diagnose a patient with hyperprolactinemia, the doctor performs a comprehensive examination. First of all, a visual inspection and conversation is carried out. Based on the results of these procedures, the specialist appoints additional studies, which include:

• blood samples to determine the level of prolactin;
• determination of indicators of the level of thyroid hormones;
• examination by an ophthalmologist (a specialist examines the fundus of the eye to exclude the possibility of developing a tumor in the pituitary gland);
• magnetic resonance therapy;
• CT scan;
• x-ray of the head in 2 projections, namely craniography and craniogram (helps to find out what condition the Turkish saddle is in).

If the doctor suspects that his ward has hyperprolactinemia, the diagnosis is made taking into account the gender of the patient. The sampling of biomaterial in women is done 5-8 days after the start of the menstrual cycle. Men can take tests for research on any convenient day.

With hyperprolactinemia, the examination involves taking blood on an empty stomach. It is recommended to stop sexual contact a day before the test. If the results of the research work show a high level of prolactin, they are repeated 2 more times. This will help eliminate the slightest chance of inaccuracies. In general, blood is taken three times in the morning to detect the level of prolactin (from 9 to 11 hours). It is after a night's sleep that the level of prolactin is at the most accurate level.

Determining the level of thyroid hormones when hyperprolactinemia is suspected is of great importance for a correct diagnosis. The data obtained help confirm the pathology of the pituitary gland (which produces prolactin), or refute the assumptions of physicians. Such analyzes are also necessary to detect hypothyroidism, which becomes the cause of the development of spontaneous galactorrhea.

The course of treatment for prolactinemia is developed based on the results of diagnostic procedures.

Treatment of hyperprolactinemia

How to treat hyperprolactinemia? Treatment of such a pathological condition as galactorrhea-amenorrhea syndrome is carried out with the help of drug therapy. The doctor who treats this pathology is an endocrinologist. But you also need the supervision of a gynecologist.

Drugs used to treat hyperprolactinemia

The most effective remedy in the fight against this disease is parlodel. It is prescribed both in the presence of pituitary adenoma in hyperprolactinemia, and in its absence. In any case, treatment with this remedy is effective. Parlodel is aimed at inhibiting the growth of prolactin and preventing its entry into the bloodstream, as well as inhibiting the processes of its synthesis.

Parlodel with galactorrhea-amenorrhea syndrome normalizes the secretion of prolactin. And this, in turn, has the following consequences:

• restoration of the activity of the sexual centers of the hypothalamus;
• an increase in the production of gonadotropic hormones several times;
• normalization of the menstrual cycle;
• restoration of reproductive function.

The effectiveness of this drug in the fight against the disease is confirmed by many examples of recovery. To treat a severe form of the disease, an additional drug may be added to parlodel.

Usually the drug is prescribed in the following dosage: 2.5 - 5 mg per day. In severe condition of the patient, the dose can be increased to 10-20 mg.

Pregnant women are usually not prescribed the drug. But during pregnancy and lactation, prolactin synthesis increases several times. This fact forced doctors to reconsider their decision to take the drug.

If a woman was treated with parlodel before pregnancy, the tumor did not grow. But when it is canceled, a relapse of the disease may occur. This once again confirms the need for taking the drug for pregnant women with galactorrhea-amenorrhea syndrome. Moreover, it does not affect the fetus, and children who are born to women taking parlodel are absolutely healthy.

If the disease is caused by macro- and microprolactinomas that are resistant to parlodel, surgery will be required. If a woman is not planning a pregnancy, you can take your time with the operation, watching the course of the disease. Surgical intervention is required only in case of obvious tumor growth. Radiation therapy, which was often prescribed in the past for the treatment of galactorrhea-amenorrhea syndrome, does not guarantee a complete recovery.

Parlodel treatment may not give a positive result if the patient has severe hyperprolactinemia and a very low blood concentration of gonadotropic hormones and estrogens. For the treatment of such patients, the drug clostilbegit is used, which stimulates the release of FSH and LH into the blood. It is also effective to introduce gonadotropic hormones into the blood, which contain FSH and LH in a 1: 1 ratio.

Galactorrhea-amenorrhea syndrome: prognosis

With proper and timely treatment of galactorrhea-amenorrhea syndrome, the patient has a good chance for a healthy life and preservation of reproductive function.

Galactorrhea - amenorrhea syndrome: treatment and prognosis

Hyperprolactinemia syndrome is a hormonal disease that can affect both the female and male body. In women, the level of prolactin in the blood changes much more often. This is due to a change in hormonal levels during menstruation, pregnancy or breastfeeding a newborn baby. In fact, prolactin is a sex hormone, so successful conception, a favorable pregnancy, childbirth and breastfeeding depend on it. Violation of ovulation, lack of menstruation, difficulty conceiving a child and infertility - this is what leads to a high level of prolactin in the blood of a woman.

The problem of hyperprolactinemia and pregnancy

During the period of gestation, in many women, the amount of prolactin in the blood exceeds medical indicators. Doctors call this the physiological norm. An increase in the concentration of this hormone occurs from the 2nd to the 6th month of pregnancy. Then the level of prolactin decreases slightly, and the new indicators are maintained until childbirth. There are cases when, against the background of the pathology of the pituitary gland (for example, the development of an adenoma in this gland), the amount of prolactin remains high. This leads to an unfavorable course of pregnancy in the later stages. The task of medical specialists in such a situation is to identify the causes of the increased concentration of lactation hormone and adequate treatment (which will help stabilize the condition of the expectant mother).

It should be noted that drug therapy at high concentrations of prolactin in the blood of a pregnant woman is contraindicated. Hormonal drugs should not be taken, because they will provoke a malfunction in the hormonal system, and the result of this will be a spontaneous abortion. If the cause of the pathology is a pituitary adenoma, it is also prohibited to carry out therapy using anticancer drugs. Drugs against tumors are highly toxic, so taking them during pregnancy often leads to a violation of the intrauterine development of the baby. The only way out that will help reduce prolactin is folk preparations with a tonic and sedative effect, which are used for symptomatic therapy.

Hyperprolactinemia: treatment with folk remedies

Treatment of hyperprolactinemia with folk remedies is well suited for those whose increase in prolactin is not associated with a somatic disease and occurred on the background of stress or physical overload. The main herbs that are used for this pathology are sage and elecampane. An effective course of herbal medicine from several herbs is also common: motherwort, peony root, hops, adonis, mint, mother liquor.

Planning pregnancy with hyperprolactinemia

Hyperprolactinemia and pregnancy are concepts that are interconnected with each other. After the conception of a child, the level of the hormone prolactin rises, and as a result, hyperprolactinemia develops. Pathology, in which the activity of the eggs is suppressed and the sexual desire is significantly reduced, occurs due to the “blocking” of the production of progesterone (pregnancy hormone). An unfavorable situation develops due to an excess of prolactin in the body and is often accompanied by such signs:

• there is insufficiency of the 2nd menstrual phase;
• no ovulation;
• The endometrium (uterine mucosa) grows very slowly, so there are problems with conceiving a baby and bearing a fetus.

If a woman is diagnosed with hyperprolactinemia and pregnancy planning is at risk, the doctor conducts a set of research activities. Diagnostic procedures help to quickly identify the cause of the excess of prolactin and direct efforts to eliminate the problem. A woman must:

• consult with an ophthalmologist (the visual fields and the fundus are examined);
• do an MRI of the pituitary gland;
• a blood test that needs to be taken several times, at different periods of the menstrual cycle, for several months (this allows you to track changes in the level of prolactin over time).

In 80% of cases, after drug therapy, the level of prolactin in the blood stabilizes, and the woman gets every chance to become pregnant, bear the baby and give birth to him.

Hyperprolactinemia after childbirth is the main cause of menstrual irregularities. Lactational amenorrhea develops due to excess levels of prolactin, which stimulates the production of breast milk. During breastfeeding, high levels of prolactin are considered normal. But if a woman has stopped breastfeeding, and prolactin has remained at the same level, it is necessary to begin treatment of hyperprolactinemia. Perhaps the pathology developed due to prolactinoma (benign pituitary tumor) or hypothyroidism (thyroid disease).

Women with postpartum hyperprolactinemia complain not only about the absence of menstruation. They develop additional symptoms in the form of a headache and the presence of milk in the breast (although the feeding of the newborn has already been stopped). Fortunately, hyperprolactinemia is now easily corrected. Women with this problem are prescribed medications that help reduce the amount of prolactin:

• Cabergoline;
• Metergolin.

If hypothyroidism has become the cause of hyperprolactinemia, the patient is recommended to take a course of taking L-thyroxine. To stop the production of breast milk, you need to take the following medications:

• Parlodel;
• Abergin;
• Lisenil;
• Bromocriptine.

When a woman has hyperprolactinemia,
Infertility is an accompanying and unpleasant factor in this pathology. According to medical statistics, about 40% of infertility cases are caused by pathological processes in the endocrine system. Hyperprolactinemia is one of the most common causes of endocrine infertility. Often women turn to a gynecologist because they cannot conceive a child, and during the examination, high levels of prolactin are found in their blood. Usually, pregnancy does not occur with such indicators, but there are cases when conception occurred with an increased level of prolactin. Such patients are prescribed the drug Parlodel, which helps to regulate the level of the hormone and reduce the risk of developing prolactinoma. It does not harm the fetus and helps to carry the baby without complications. Pregnant women with hyperprolactinemia syndrome should periodically consult an ophthalmologist and neurologist.

- this is a certain state of the body in which too intense production is manifested. Accordingly, its level in the blood rises significantly. This disease is more common in women, but it also occurs in men. Most often, hyperprolactinemia is diagnosed in women aged 25 to 40 years.

Prolactin formation

In addition to the functions described above, prolactin is responsible for the regulation of water-salt metabolism in the human body: the kidneys, under its influence, remove water and salt more slowly.

Causes of hyperprolactinemia

Experts identify many different causes, eventually leading to the development of hyperprolactinemia. It is customary to distinguish physiological and pathological forms of the disease. In healthy women, an increase in the level of prolactin in the body occurs under the influence of certain physiological factors. For example, the level of prolactin can increase during sleep, during breastfeeding, due to strong or serious physical exertion, during sexual contact, during pregnancy and in the period after the birth of a child.

Pathological hyperprolactinemia , in turn, subdivided into organic and functional . The development of the organic form of the disease occurs due to the appearance of pituitary tumors - the so-called microprolactinoma and macroprolactinoma . These tumors are benign, but they overproduce prolactin. They tend to grow very slowly, and sometimes may not grow at all. But until now, it is not known exactly which factors directly affect the appearance of such formations. The size of prolactinomas can be different, but nevertheless, formations are most often found, the diameter of which does not exceed 10 mm. In this case, we are talking about microprolactinoma. In rarer cases, doctors find pituitary tumors that are larger than 10 mm in diameter. Such formations are called macroprolactinomas. Manifestations of functional hyperprolactinemia are associated with a variety of diseases. So, this pathology can manifest itself with hypertriosis - insufficient function of the thyroid gland; at chronic renal failure , polycystic ovary syndrome, as well as some other diseases. If a woman has undergone surgery or trauma in the chest area, reusable curettage of the uterine cavity, then in the future the development of hyperprolactinemia is also likely. Quite often, functional hyperprolactinemia manifests itself in women who suffer from various gynecological diseases. So, this form of this disease affects women with development inflammatory processes .

Some medications that are prescribed in high doses can also affect the increase in prolactin levels. This effect is typical for antidepressants , neuroleptics , drugs with hypotensive effect , estrogen , prostaglandins , oral contraceptives .

However, there is another form of the disease - the so-called idiopathic hyperprolactinemia . In this case, the patient has an increased level of prolactin in the body, but there are no causes that cause such a pathology. In this case, an excess of prolactin appears due to too high function of the pituitary cells. However, their number at the same time remains normal or increases very little.

Symptoms of hyperprolactinemia

If the patient has an increased level of prolactin in the blood, then such a pathology may have different symptoms. If a woman develops hyperprolactinemia, the symptoms of this condition are manifested by a delay in menstruation, its complete absence, or insufficiency of the second phase of the monthly cycle. The ovulation cycle may be disrupted, while periodically colostrum or milk is released from the mammary glands. In view of such serious violations of the menstrual cycle, the result of hyperprolactinemia can be female infertility . In addition to the manifestations described, with hyperprolactinemia in women, an increase in the size of the mammary glands is sometimes observed, as well as the development of either breast cysts . Over time, these benign formations can degenerate into.

At the same time, an increased amount of prolactin in the body of a man affects the formation of testosterone: its content in the blood decreases. The result of this phenomenon is a decrease libido , that is, interest in sexual life. Due to the progression of the disease in men, inhibition of the maturation of spermatozoa in the testicles is observed, sometimes manifestation gynecomastia (enlargement of the mammary glands), as well as galactorrhea (colostrum flows out of the nipples). Later, a man may develop, as well as infertility.

Therefore, the symptoms of hyperprolactinemia should be a reason for immediate referral to a specialist for both sexes.

Diagnosis of hyperprolactinemia

The most important method in the process of examining patients with suspected hyperprolactinemia is a hormonal examination, in which it is possible to accurately determine the content of prolactin in the blood. To conduct such a study, a woman takes blood from a vein, and this must be done in the morning, between the 5th and 8th days of the menstrual cycle. Before the analysis, you can not have sex for one day, drink alcohol, go to the sauna. It is important to avoid stressful situations and exposure to the mammary glands. If during the first study an increased content of prolactin in the blood was found, then later it is necessary to conduct repeated hormonal studies, and there should be at least three of them. The fact is that a once-detected increase in prolactin may be temporary and not indicate the development of a certain ailment in a woman's body.

In the process of diagnosing organic hyperprolactinemia, an examination of the pituitary gland is performed. For this, the method of craniography is used - an X-ray image of the skull in two projections. In addition, informative and accurate examination methods in this case are computed tomography and magnetic resonance imaging.

Treatment of hyperprolactinemia

Currently, the treatment of hyperprolactinemia is carried out using certain medications. Most often, to normalize prolactin, patients are prescribed drugs, norprolac , (). Due to the effect of these drugs, a few weeks after the start of treatment, the production of prolactin by the tumor decreases to normal levels. If the content of prolactin in the blood is normalized, then women also note the restoration of the menstrual cycle. Accordingly, there is a restoration of the woman's ability to conceive a child. In this case, pregnancy after normalizing the level of prolactin can occur already in the next cycle. Therefore, those women who do not plan to give birth to a baby in the near future should carefully choose the most suitable method of contraception for them.

After the course of treatment in men, normal testosterone levels are restored. As a result, sexual desire resumes, and the man's sex life returns to normal.

When treated with the drug, there is also a gradual decrease in the size of prolactinomas. The course of treatment with Parlodel in some cases ends with a decrease in microadenoma, its necrosis and complete disappearance.

In patients with macroprolactinomas, such treatment should be accompanied by periodic tomographic examination in order to assess the change in the size of the prolactinoma over time.

In view of the proven effectiveness of drug treatment, the presence of prolactin in patients is very rarely an indication for surgery and radiation therapy. Such interventions are only reasonable in some selected cases, if macroprolactinomas do not decrease in size during drug treatment.

A woman should be aware that with a timely visit to a doctor and the correct course of therapy, the prognosis for hyperprolactinemia is quite favorable. In this case, the cured patient will be able to have children in the future.

The doctors

Medications

Prevention of hyperprolactinemia

If a woman has already had hyperprolactinemia, then she should undergo dispensary observation in order to prevent a recurrence of the disease. To do this, at least once a year, computed tomography is performed and twice a year the level of prolactin in the blood is determined.

As for the prevention of hyperprolactinemia, we cannot talk about effective methods, since the causes of the disease are very diverse. However, a woman receiving combined oral contraceptives for a long time it is necessary to determine the content of prolactin in the blood.

Hyperprolactinemia and pregnancy

Ensuring the normal functioning of the human reproductive system occurs with the direct participation of the hormone prolactin. Therefore, an increased level of this hormone stimulates the manifestation of one of the most common forms of hormonal female infertility. Hyperprolactinemia and pregnancy are a signal to the doctor that a woman must be constantly under close supervision. It is especially important to regularly visit an ophthalmologist and a neurologist. In this case, the woman, as a rule, continues to take the drug. parlodel . If the patient took this drug before the onset of pregnancy for a year or more, then the risk of further development or recurrence of prolactinoma is significantly reduced. Therapy with the use of this drug during the period of bearing a child is safe for both mother and baby.

In the normal course of pregnancy in a healthy woman, the content of prolactin in the body increases from 8 to 25 weeks. Immediately before childbirth, the level of prolactin decreases, and during breastfeeding it rises again.

List of sources

• Dedov I.I., Melnichenko G.A., Romantsova T.I. Syndrome of hyperprolactinemia. // M.: Triada, 2004;
• Vikhlyaeva E.M. Guide to endocrine gynecology. - M.: MIA, 2000;
• Melnichenko G.A. et al. Hyperprolactinemia in women and men. A guide for doctors. M., 2008;
• Melnichenko G.A. Clinical endocrinology. // Ed. II.T. Starkova. - M., 1998;
• Endocrinology: a national guide. Ed. I.I. Dedova, G.A. Melnichenko. M.: GEOTAR-Media, 2008.