Prolactin What we need to know

15.12.2022

A prolactin (PRL) test measures the level of prolactin in the blood. Prolactin is a hormone produced in the pituitary gland. Reproductive health of men and women, quality of sexual life, metabolism and even a strong immune system depend on hormonal balance, including normal levels of prolactin in the blood.

Table of Contents

An increased level of prolactin in the blood, in the case of women, causes: disturbance of the menstrual cycle, infertility or the problem of conceiving. For men: decreased libido and impaired sex life.

Prolactin causes breasts to grow and produce milk after pregnancy and childbirth. Prolactin levels are usually high in pregnant women and newborns.

If the prolactin level is higher than normal, it often indicates a pituitary tumor known as a prolactinoma. A pituitary tumor causes the gland to produce an excessive amount of prolactin.

The excess of prolactin is caused by:

Prolactinoma (a benign tumor in the pituitary gland that produces too much prolactin);
Diseases that affect the hypothalamus (the part of the brain that controls the pituitary gland);
Anorexia (eating disorder);
Medicines used to treat depression, psychosis and high blood pressure.
Decreased thyroid function;
Kidney disease;
nipple stimulation;
Polycystic ovary syndrome.

Prolactin test

The purpose of determining the prolactin content in the blood is:

determination of the cause of galactorrhea or milk secretion;
Determining the cause of headache and visual impairment with it;
determining the cause of infertility and erectile dysfunction in men;
determining the cause of infertility in women;
diagnostics of prolactinoma;
determination of pituitary function;
Monitoring in the treatment of prolactinoma.

Symptoms

Determination of prolactin is usually done during the research of the hormonal background and/or the following complaints:

constant headache;
significant decrease in vision;
secretion of milk in non-pregnant women and men;
menstrual cycle disorder;
male and female infertility;
Decreased libido, erection and impotence problems in men;
Also, when researching the function of the pituitary gland.

Prolactin in women

Women who have gone through menopause may not even have symptoms of prolactin level disorders until the said pathological condition worsens.

Excess prolactin after menopause often leads to hypothyroidism. The symptoms of the pathology are as follows:

weakness (absence of energy);
depression;
weight gain;
muscle pain
Intolerance of cold temperatures.

Excessive prolactin in women who have not gone through menopause, the symptoms of the pathology include:

menstrual cycle disorders;
Infertility;
Breast tenderness.

Prolactin in men

Symptoms of excess prolactin in men include:

discharge from the chest;
breast enlargement;
low sexual desire;
Erectile dysfunction;
Hair loss on the body.

Common symptoms

Symptoms of excess prolactin in women and men include:

unexplained headache;
vision problems.

How to take the test

Due to the fact that the level of prolactin in the blood changes during the day, the study is carried out in the morning, 3-4 hours after waking up. The patient should be fasting, in a calm state. During the preparation period, i.e. 24 hours before the analysis, it is recommended to avoid physical and emotional stress, fatty foods, and alcohol. The test involves taking a blood sample from an arm vein.

Often, the prolactin level in the blood is affected by such factors as: pregnancy, different phases of the cycle, menopause, as well as medications (especially hormonal) that the patient may be taking. In such a case, you should definitely consult a doctor before the analysis.

test results

excess

If the test shows that the patient has an amount of prolactin in the blood that is higher than normal, this may indicate various complications, such as:

Prolactinoma (a type of pituitary tumor);
Hypothyroidism;
Hypothalamic disease. The hypothalamus is the area of the brain that controls the pituitary gland and other body functions;
Liver disease.

deficit

If the test shows a low prolactin level, the condition often does not require medical treatment.

Some medications can cause low prolactin levels.

norm

In the case of research with different methods, the norm of prolactin is different, which is why the laboratory should indicate the limits of the norm along with the results of the research. For non-pregnant women, the normal range for prolactin is 4-23 nanograms per milliliter (ng/mL) or 4-23 micrograms per liter (mcg/L). for men – 3-15 ng/ml or 3-15 μg/l; For pregnant women – 34-386 ng/ml or 34-386 mcg/l.

Treatment

The main goal of treatment is to normalize prolactin secretion, restore reproductive function and disappear other symptoms of the disease. Treatment tactics are different and depend on the cause of the problem.

Hyperprolactinemia is subject to medical treatment, taking into account a doctor's visit and his recommendations. The doctor periodically checks the prolactin content in the blood with a laboratory test to determine the effectiveness of the treatment. In the case of a large growing adenoma of the pituitary gland, surgical treatment may be considered necessary.

Discontinuation of any type of prolactin medication without consulting a doctor is not allowed - this may lead to tumor recurrence. If we did not get the desired result even after 5 years from the start of medical therapy, the issue of surgical treatment is raised. In those rare cases, when surgical treatment is ineffective, radiation therapy is included in the treatment. The prognosis is almost always favorable. Malignancy of the tumor occurs very rarely.