All about prolactin

Prolactin, popularly known as milk hormone, is the hormone whose main function is to stimulate milk production. It is present in the blood in small quantities and is mainly produced by the pituitary gland, a gland located in the central nervous system of the brain that causes the hormone production to increase during pregnancy and postpartum to be able to feed the baby.

However, outside the gestational period this hormone can also be produced in men and women and when this production occurs at levels exceeding normal, it is called hyperprolactinemia, a problem that may interfere with sexual and reproductive functions and is responsible for almost 20% of female infertility cases.

Interestingly, hyperprolactinemia is a disease that can affect people of both sexes, but is more common in women aged 20 to 50 years.

Prolactin is also important for ovulation, breast development and lactation during pregnancy. Outside this period, it helps control other types of hormones.

What are the causes of hyperprolactinemia?

Several factors may contribute to the increase in prolactin levels in the blood, the most common being pregnancy, stress, excessive nipple stimulation, chest wall diseases, the use of certain medications such as antidepressants, antipsychotics, anti- nausea, anti- hypertension, as well as problems such as hypothyroidism, polycystic ovary syndrome, kidney disease, prolactin molecule changes, and diseases affecting the central nervous system such as trauma, infections, and tumors. There are also cases in which hyperprolactinemia has no known cause and is now called idiopathic.

What are the symptoms?

Symptoms vary by gender and cause of illness, but the most common include menstrual changes such as missed menstruation (amenorrhea) or menstrual irregularity (oligomenorrhea), decreased fertility and difficulty in getting pregnant, producing and leaking out of milk. gestational period (galactorrhea), vaginal dryness, lack of sexual desire and erection difficulties, osteoporosis in both sexes and when caused by tumors, can lead to headaches and vision problems.

How is the diagnosis made?

To detect hyperprolactinemia, physicians look at the patient's history and perform standard blood tests that measure prolactin levels in the blood and, if a tumor is suspected, perform magnetic resonance imaging on the pituitary gland.

How is the treatment done?

Treatment depends on the cause, but in all cases, even when tumors occur, treatment is done using drugs that normalize prolactin levels, shrink the tumor and restore sexual and reproductive functions in approximately 80% of patients. cases.

In the other 20% of cases, when the tumor does not react to drug treatment, surgical intervention or radiotherapy may be required. Surgery is performed through the nose, which eliminates the need to open the skull and the incidence of scarring.

If you have any suspicion or symptoms related to hyperprolactinemia, consult an endocrinologist to clarify your doubts, perform tests and, if appropriate, start treatment. Take care!

Pituitary Tumors - Mayo Clinic (April 2024)