Hyperprolactinemia

July 18, 2012

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Hyperprolactinemia   - A certain state of the body, causing them to exhibit very intensive production prolactin . Accordingly, its level in blood is considerably increased. This disease is more commonly seen in women, but it also occurs in men. The most frequently diagnosed hyperprolactinemia in women whose age is between 25 and 40 years old.

Education prolactin

Prolactin, like a number of other hormones In the human body is formed pituitary . It is also called "milk" hormone prolactin as it stimulates the appearance of milk in the woman who gave birth to the baby. At the same moment males active hormone produced in much smaller quantities.

In addition to the endocrine pituitary gland also produces prolactin luteinizing   (LH) and follicle-stimulating   (FSH), hormones. These hormones are responsible for the regulation of offensive Ovulation   and menses . In addition, they stimulate the production of the female body estrogen And oocyte maturation. In the male body, these hormones are responsible for the production of Testosterone , The male sex hormone and regulate the level of mobility sperm . Accordingly, patients with hyperprolactinemia prolactin concentration in blood abruptly rises.

Prolactin stimulates the production of Colostrum   at the beginning of lactation, and later contributing to its transformation into mature milk . Prolactin also directly affect the growth of the mammary glands, as well as an increase in the number of ducts and lobules. The effect of this hormone in the female body manifests the existence of an extension of the corpus luteum of the ovaries and inhibition of ovulation. Therefore, the inhibition of the new conception. If this mechanism is correct, then the prolactin helps prevent pregnancy   and the absence of menstruation during breast-feeding . However, abnormally high content of prolactin in women is fraught manifestation frigidity . anorgasmia   and infertility .

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

Causes of hyperprolactinemia

Experts identify many different reasons, ultimately leading to the development of hyperprolactinemia. To distinguish physiological   and pathological   form of the disease. In healthy women, elevated prolactin levels in the body is under the influence of some physiological factors. For example, prolactin levels may increase during sleep, during breastfeeding, due to the strong stress   any major physical exertion during sexual intercourse, during pregnancy and after birth.

Pathological hyperprolactinemia In turn, divided into organic   and functional . The development of organic form of disease is due to the occurrence of pituitary tumors - the so-called mikroprolaktinom   and makroprolaktinom . These tumors are benign, but they produce hard prolactin. They usually grow very slowly and sometimes may not grow at all. But to date it is not known which factors directly affect the appearance of such entities. Prolactin size can vary, but still the most frequently found formation, the diameter which does not exceed 10 mm. In this case, we are talking about mikroprolaktinome. More rarely exhibit doctors pituitary tumors, which have a diameter greater than 10 mm. Such formations are called macroprolactinoma. Manifestations functional hyperprolactinemia associated with various diseases. So, this pathology can appear at gipertrioze   - Failure of the thyroid gland; at chronic renal failure . polycystic ovary syndrome, cirrhosis And some other diseases. If a woman had surgery or trauma in the chest, reusable curettage of the uterus, in the future is also likely to develop hyperprolactinemia. Quite often functional hyperprolactinemia manifested in women who suffer from various gynecological diseases. Thus, this form of the disease affects women with endometriosis . uterine myoma , Development inflammation .

On the increase in prolactin levels may affect some medicated preparations that are assigned in large doses. These effects are for Antidepressants . neuroleptics , Drugs with hypotensive effect . estrogen . prostaglandins . oral contraceptives .

However, it stands another form of the disease - the so-called idiopathic hyperprolactinemia . When this occurs the patient has increased level of prolactin in the body, but it causes a pathology, no. In this case, an excess of prolactin occurs due to too high function pituitary cells. However, the number remains in the normal or increases very little.

Symptoms of hyperprolactinemia

If the patient has increased level of prolactin in the blood, then such a pathology can have different signs. If a woman develops hyperprolactinemia, the symptoms of this condition appear delayed menstruation, her complete lack of any failure of the second phase of the menstrual cycle. It can disrupt ovulation cycle, while periodically released from breast milk or colostrum. In view of such serious violations of the menstrual cycle can be a result of hyperprolactinemia anogyny . Besides these manifestations, with hyperprolactinemia in women is sometimes an increase in breast size, as well as the development Adenomas   or lactocele . Over time these benign growths can be reborn in breast cancer .

At the same time, an increased amount of prolactin in the male affects the formation of testosterone: its content in blood decreases. The result of this phenomenon becomes decrease libido That is of interest in sexual activity. Due to the progression of the disease in men observed inhibition of maturation of sperm in the testicles, it is sometimes possible manifestation gynecomastia   (breast enlargement), and galaktorei   (follows from the nipple colostrum). Later, a man can develop impotence And infertility.

Hence, the symptoms of hyperprolactinemia should be cause for immediate referral to a specialist for members of both sexes.

Diagnosis hyperprolactinaemia

The most important method in the process of examination of patients with suspected hyperprolactinemia is a hormone test that possible accurate determination of prolactin in the blood. To carry out such studies in women produce blood sample from a vein, and this should be done in the morning, between the 5th and 8th days of the menstrual cycle. Before the analysis can not be for one day to have sex, drink alcohol, use of the sauna. It is important to avoid stressful situations and the effects on the mammary gland. If in the first study found increased content of prolactin in the blood, it is necessary to later re-hormonal studies, and, should be no less than three. The fact that the observed increase once prolactin may be temporary and not indicative of the development of a woman's body a certain disease.

In the process of diagnosis of organic hyperprolactinemia conducted a survey area of ​​the pituitary gland. To do this, use the method craniography - X-ray of the skull in two projections. In addition, informative and accurate methods of examination in this case are computed tomography and magnetic resonance imaging.

Treatment of hyperprolactinemia

Currently, treatment of hyperprolactinemia conducted using several drugs. Most often patients to normalize prolactin prescribe drugs bromocriptine . norprolak . Cabergoline   ( dostineks ). Due to the effects of these drugs a few weeks after the start of treatment tumor prolactin production is reduced to normal levels. If the content of prolactin in the blood normalizes, women celebrate and restore the menstrual cycle. Accordingly, it is a restoration of a woman's ability to conceive. At the same time pregnancy after correction of the excess prolactin levels may occur already at the next cycle. Therefore, those women who do not platiniruyut soon give birth to a baby should carefully choose the most suitable for their method of contraception.

After a course of treatment in men occurs restore normal testosterone levels. As a result, the sex drive is resumed, and the sexual life of a man is normalized.

In the treatment of drug parlodel   It occurs as a gradual reduction in the size of prolactin. Parlodel course of treatment in some cases a decrease in completed microadenomas, necrosis and its complete disappearance.

Patients with macroprolactinoma such treatment must be accompanied by a batch tomography to assess the dynamics of change in the size of prolactinomas.

In view of the proven effectiveness of treatment with the presence of drugs in patients with prolactin is a very rare indication for surgery and radiation therapy. Such interventions are suitable only in certain specific cases, if macroprolactinoma not decrease in size in the course of treatment drugs.

Women should be aware that with timely treatment to the doctor, and the right course of treatment of hyperprolactinemia prognosis is quite favorable. This cured the patient in the future be able to have children.

Hyperprolactinemia and pregnancy

Ensuring the proper functioning of the human reproductive system comes with the direct participation of the hormone prolactin. Therefore, elevated levels of this hormone stimulates the expression of one of the most common forms of hormonal female infertility. Hyperprolactinemia and pregnancy - is a signal to the doctor that a woman must always remain under close supervision. It is especially important to regularly visit an ophthalmologist and neurologist. This woman, as a rule, continue to take the drug parlodel . If this drug is taken ill before pregnancy and for a year or longer period of time, the risk of any further development of prolactinoma recurrence is significantly reduced. Therapy with the use of this drug during childbearing is safe for both the mother and for the baby.

In the normal course of pregnancy in healthy women prolactin levels in the body increases from 8 to 25 weeks. Just before birth prolactin level decreases, and during breast-feeding again increases.

Prevention of hyperprolactinemia

If a woman has already had hyperprolactinemia, it should undergo follow-up, to prevent the recurrence of the disease. To do this at least once a year, the computed tomography and made twice a year to determine the level of prolactin in the blood.

With regard to prevention of hyperprolactinemia, about the good practices we can not go, because the cause of the disease is very diverse. However, the woman at reception combined oral contraceptives   for a long time, be sure to determine blood levels of prolactin.