What is Prolactin? What are the Causes of High Prolactin?

Prolactin is a hormone produced and secreted by the anterior pituitary gland, a gland in the brain. It plays an important role in regulating reproductive and breastfeeding functions in women. Higher-than-normal levels of prolactin in your blood can cause certain symptoms, such as irregular menstrual periods, infertility and erectile dysfunction.

What is Prolactin?

Prolactin is a hormone produced by your pituitary gland, located in the lower part of the brain. It helps the woman’s breasts grow and develop. Thanks to this hormone, milk production begins after the baby is born. Both men and women normally have small amounts of prolactin in their blood. Prolactin levels are controlled by other hormones called prolactin inhibitory factors (PIFs), such as dopamine. Prolactin levels rise during pregnancy.

During pregnancy, prolactin, estrogen and progesterone hormones stimulate the development of breast tissue and milk production.

Prolactin supports the growth of a certain type of breast tissue called mammary alveoli, which are components of the mammary gland where milk production occurs. Prolactin also stimulates breast alveolar cells to produce milk components, including:

• Lactose (carbohydrate component of milk)
• Casein (protein component of milk)
• Lipids (energy-providing components, essential fatty acids and cholesterol)

After your baby is born, progesterone levels drop. This increases the number of prolactin receptors in breast alveolar cells. This is the system that allows milk to be secreted from your nipple. It is commonly known as lactation.

After birth, prolactin levels do not remain consistently high. Prolactin levels only rise during your baby’s periods of nipple stimulation through suckling. As long as your baby continues to breastfeed, prolactin levels remain high. When you are not breastfeeding, your prolactin levels drop and milk production decreases. If a person does not breastfeed her baby, prolactin levels drop to non-pregnant levels after one to two weeks.

How Much Should Prolactin Be?

Normal value ranges for prolactin levels may vary slightly between different laboratories. Be sure to look at the normal range listed on your lab report, or consult your doctor if you have questions about your results. Normal values ​​for prolactin are generally:

• Men: Less than 20 ng/mL (nanograms per milliliter).
• Women and people who are not pregnant or breastfeeding: So is 25 ng/mL.
• Pregnant or breastfeeding people: 80 to 400 ng/mL.

What Does High Prolactin Mean?

Outside of pregnancy and breastfeeding, high prolactin levels may indicate an endocrine disorder or other health problem. Symptoms of high prolactin include breast enlargement, irregular menstrual periods, irritability and low sexual desire. Elevated prolactin, also known as hyperprolactinemia, indicates increased prolactin levels in the blood. In women, it can lead to irregular menstruation, amenorrhea (absence of menstruation), galactorrhea (unwanted milk production), infertility and decreased sexual desire. In men, hyperprolactinemia can cause erectile dysfunction, decreased sexual desire, and gynecomastia (enlarged breasts).

What Causes High Prolactin?

The pituitary gland’s secretion of prolactin is regulated by two hormones:

• dopamine: It is a hormone produced by the adrenal glands and slows down the production of prolactin.
• Thyrotropin-releasing hormone (TRH): This is a hormone produced by the hypothalamus that increases prolactin production.

When prolactin levels are abnormally high, it is due to conditions that reduce dopamine production, increase TRH production, or both. This can be caused by diseases or disorders that directly or indirectly affect the function of the HPA axis. The most common cause of hyperprolactinemia is a type of pituitary tumor known as a prolactinoma. This benign tumor tends to occur without any known cause. However, there are a few types that can be inherited from parents. Some of the causes of high prolactin can be listed as follows:

• Benign brain tumors: These include noncancerous tumors such as pituitary adenomas, craniopharyngioma, and meningioma.
• Trauma: It includes injuries sustained during surgery or irradiation of the pituitary gland, adrenal glands, or hypothalamus.
• Hypothyroidism: This condition occurs when the thyroid gland does not produce enough thyroid hormone, causing an increase in TRH.
• Cushing’s syndrome: This is a condition caused by abnormally high levels of the stress hormone cortisol.
• Systemic diseases: They are whole-body diseases that directly or indirectly affect the endocrine (hormonal) system, such as chronic kidney disease (CKD) and liver disease.
• Medicines: These include drugs that increase prolactin secretion, some antidepressants, antipsychotics, opioids, estrogen, H2 blockers, and high blood pressure medications.
• Acromegaly: This is a hormonal disorder that occurs when the pituitary gland produces too much growth hormone (GH) and other hormones are out of balance.
• Lymphocytic hypophysitis: It is an autoimmune disease that causes inflammation of the pituitary gland.
• Rathke’s Cyst: It is a fluid-filled growth that develops between parts of the pituitary gland.
• Cancer: These include dysgerminoma (a type of ovarian cancer) or brain metastases (cancers that have spread to the brain).

What are the symptoms of high prolactin?

Women are affected by hyperprolactinemia more frequently than men. Studies show that three in five women with reproductive disorders will have high prolactin. Symptoms of high prolactin in women include:

• menstrual irregularity
• Loss of libido (sexual drive)
• Galactorrhea (producing breast milk even though you are not pregnant or breastfeeding)
• Infertility (due to lack of ovulation)
• hot flashes
• vaginal dryness
• weight gain
• breast tenderness
• Acne
• Hirsutism (excessive body and facial hair growth)

High prolactin levels in men are manifested by the following symptoms:

• loss of libido
• erectile dysfunction
• Infertility (due to decreased sperm production)
• Gynecomastia (abnormal breast growth)
• Galactorrhea (rare but possible)

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What Should Not Be Consumed When Prolactin Is High?

High prolactin can be caused by various reasons, from pituitary gland tumors to hormone imbalances. To manage this condition, it is important to pay attention to your diet. Avoiding certain foods and substances that can negatively affect prolactin levels can help maintain hormone balance.

• Caffeine consumption can increase prolactin levels, which can be harmful to people with hormone imbalances. Individuals experiencing high prolactin levels are advised to limit or completely cut out caffeine intake. It may be especially useful for people with high daily caffeine consumption to review their habits.
• Soy contains phytoestrogens, known as phytoestrogens. Phytoestrogens can have a similar effect to the estrogen hormone in the body. This may cause prolactin levels to increase.
• Foods containing high fat can lead to overall hormonal imbalances in the body and negatively affect prolactin levels. Saturated fats and trans fats, in particular, can affect the production and secretion of hormones.
• High-sugar foods and refined carbohydrates can cause spikes in blood sugar levels. This can lead to hormonal imbalances.

Treatment of High Prolactin

High prolactin levels without symptoms may not require treatment. The goal of hyperprolactinemia treatment is to restore normal prolactin levels and relieve symptoms. This can usually be done by treating the underlying cause. Drug-induced hyperprolactinemia is treated by reducing the dose or prescribing a different drug. High prolactin levels due to hypothyroidism are treated with synthetic thyroid hormone. For this reason, the condition that causes prolactin elevation is determined and the treatment is planned to suit this situation.

What Does Low Prolactin Mean?

A low prolactin value, also known as hyperprolactinemia, means that prolactin levels in the blood are below normal reference ranges. However, hyperprolactinemia is relatively rare. One study found that in women of reproductive age, a prolactin level of less than 5 ng/mL may increase a woman’s risk of metabolic syndrome. Metabolic syndrome is a group of medical conditions, including high blood pressure and high blood triglycerides, that collectively increase your risk of heart disease, stroke, and diabetes.

Low Prolactin Treatment

If your prolactin levels are below the normal range, this may mean that your pituitary gland is not producing one or more of the hormones it normally produces. Low prolactin usually does not require medical treatment.

Which Diseases is Prolactin Testing Done for?

The prolactin (PRL) blood test measures how much of a hormone called prolactin is in your blood. The hormone is produced in your pituitary gland, located just below your brain. Prolactin testing is used in the diagnosis of the following diseases:

Pituitary Gland Tumors (Prolactinoma)

One of the most common uses of the prolactin test is the diagnosis of tumors that may occur in the pituitary gland, especially prolactin-secreting tumors called prolactinoma. Prolactinoma is a benign tumor of the pituitary gland and can cause menstrual irregularities in women and sexual dysfunction in men. High prolactin levels may indicate the presence of these tumors, and prolactin testing is critical for early diagnosis of this condition.

Hormone Imbalances

It is also used in the diagnosis of hormone imbalances. High prolactin levels in women can lead to disruption of the menstrual cycle and even infertility. In men, high prolactin levels can cause decreased testosterone production and sexual dysfunction. Prolactin tests play an important role in diagnosing such hormonal imbalances.

hypothyroidism

The test can also help diagnose conditions where the thyroid gland is underactive, such as hypothyroidism. Hypothyroidism is characterized by low production of thyroid hormones, which can cause prolactin levels to rise. Prolactin testing provides a more comprehensive evaluation when used in conjunction with thyroid hormone tests in the diagnosis of hypothyroidism.

Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS), It is a hormonal disorder common in women. This condition is characterized by ovaries not functioning properly and hormone imbalances. In women with PCOS, prolactin levels may be higher than normal, which can lead to menstrual irregularities, infertility, and other health problems. The prolactin test is used along with other hormone tests to diagnose PCOS.

acromegaly

It can also be used in the diagnosis of a rare disease called acromegaly, which is characterized by excessive production of growth hormone. Acromegaly causes abnormal growth of body tissues and is usually caused by a tumor in the pituitary gland. High prolactin levels may indicate the presence of such a tumor, and in this case prolactin testing is an important tool for early diagnosis of acromegaly.

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