Understanding prolactin and the prolactin test
Prolactin is produced within the brain through the pituitary gland. It is also known as PRL, or hormone lactogenic. Principally, prolactin is used to help women produce milk after birth.
It is critical for reproductive health, for both males and females. Prolactin’s unique role in men isn’t well known. Prolactin levels were however used in both men and women to assess sexual satisfaction. A check of the prolactin level will show certain hormone-induced problems.
Why is the prolactin test done?
Women with signs of a prolactinoma may need that examination. Prolactinoma is a non-cancerous tumor producing high amounts of prolactin on the pituitary gland.
In females, symptoms of prolactinoma include:
- unexplained headaches
- visual impairment
- galactorrhea, or lactation outside of childbirth or nursing
- pain or discomfort during sex
- abnormal growth of body and facial hair
- abnormal acne
The examination is usually performed on persons with prolactinoma to keep track of the response of the tumor to treatment.
Alternatively, if you have fertility problems or irregular periods, the prolactin test may be needed. The test could also rule out other issues with the pituitary gland or hypothalamus.
Men may need a test if they show prolactinoma symptoms. Symptoms in men with prolactinoma include:
- unexplained headaches
- visual impairment
- reduced sex drive or fertility problems
- erectile dysfunction
- abnormal lack of body and facial hair
The test may also be used to:
- investigate testicular dysfunction or erectile dysfunction
- rule out problems with the pituitary gland or hypothalamus
How is the test carried out?
A check on prolactin is like a test on the blood. In the doctor’s office or in a laboratory, it takes a few minutes. They don’t have to train for it. Usually, the sample is obtained three to four hours after morning awakening. The brain draws blood from a vein. There is very little pain in there. You may only feel slight pain when the needle goes in, and afterward a mild soreness.
The test results may be influenced by certain birth control pills, high blood pressure medications or antidepressants. Tell your doctor about any drugs that you take before the test is done. Sleeping issues, high levels of stress and strenuous exercise before the test may also affect the results.
What are the risks?
The check on prolactin bears no risk of complications. After drawing blood, you might get a small bruise at the puncture point. Leave the site under pressure for a few minutes after removal of the needle to help reduce bruise. You may feel weak or lightheaded.
In rare cases, in a condition known as phlebitis, the vein may become inflamed after the examination. Treating phlebitis with a warm compress that is applied many times a day to the wound.
If you have a bleeding disorder you can face continued bleeding. Remember, if you are taking aspirin or warfarin for blood-thinning drugs, tell your doctor before the test is done.
What are the normal results?
The doctor can decide if your results are appropriate based on a number of factors, including the overall health. The values for prolactin can vary slightly between different laboratories. Appropriate findings tend to look as follows:
What do high levels mean?
Low prolactin levels are not usually a problem in men or women. Very high levels of prolactin, known as hyperprolactinemia, may, however, suggest a deeper problem. Hyperprolactinemia occurs in about 10 percent of the population.
High prolactin levels are common during pregnancy, and during nursing after childbirth. Anorexia nervosa, liver disease, kidney disease, and hypothyroidism can also induce hyperprolactinemia, however, Hypothyroidism can cause the pituitary gland to be swollen which can be treated with thyroid hormone replacement therapy. Pituitary tumors can also cause high levels of prolactin. Such tumors can be medically or surgically treated.
Some medications can cause high levels of prolactin. Psychiatric pharmaceutical medications like risperidone and haloperidol will raise the levels. Metoclopramide can also increase the levels of prolactin. The drug is usually used for the treatment of acid reflux or cancer-caused nausea.
Some can stressors can increase levels of prolactin, too. Such stressors include low blood sugar, intense workouts and even mild forms of pain. If you find out that your levels of prolactin are high, you may need to find ways to lower your stress and keep your blood sugar stable.
Red clover, fenugreek, or fennel will boost your levels of prolactin. When you find out you have high levels of prolactin, avoid eating anything with those ingredients.
Prolactin and fertility
High levels of prolactin can induce infertility in some cases. Tumors with prolactinoma will put pressure on your pituitary gland and stop hormone production. The condition is called hypopituitarism. It triggers a lower sex drive in men and a loss of body hair. It can cause infertility in women.
Hyperprolactinemia may cause a woman to have difficulty getting pregnant. High levels of prolactin can disrupt the normal production of the estrogen and progesterone hormones. This can cause the ovaries to irregularly release or stop eggs altogether.
Medicines and other treatments for prolactinoma help restore fertility in the majority of women. If you find out that you have high levels of prolactin or tumors with prolactinoma, talk to your doctor about the therapies immediately. Often, you can ask to eliminate or raise tumors.
Treatment for high prolactin levels
The most common treatment for elevated prolactin levels is dopamine agonists such as bromocriptine (Parlodel and Cycloset). Such drugs help the brain generate dopamine that regulates high levels of prolactin. Sometimes, they can shrink tumors with prolactinoma.
Your doctor may recommend taking cabergoline. Cabergoline is a newer medication for prolactinoma, with milder side effects than other traditional prolactinoma medications. When you have serious side effects from other medications, including bromocriptine, talk to your doctor about cabergoline. Buy cabergoline online at our online pharmacy.
Not all levels of prolactin can react well to dopamine agonists. Your doctor may recommend radiotherapy if your prolactin or prolactinoma levels are not improved by those medications.
If the drug does not shrink your tumor, your doctor might recommend surgery. Surgery can take place through the nose or the upper skull. Together, surgery and medicine will make the prolactin levels normal again.
Certain steps you might take to lower the level of prolactin include:
- Changing your diet and keeping stress down
- Stop high-intensity workouts or events that get you exhausted
- Avoid clothes which make your chest uncomfortable
- Avoid clothes and practices that over-stimulate the nipples
- Taking supplements with Vitamin B-6 and Vitamin E
Vitamin B-6 is part of the dopamine production process and may reduce prolactin levels by higher levels. Vitamin E naturally prevents changes in levels of prolactin. Talk to your doctor or nutritionist before you adjust your vitamin intake or and other supplements.
If you have a disorder related to high prolactin levels, your doctor will likely refer you to an endocrinologist. An endocrinologist can assist in guiding you through treatment or surgery.
Your doctor may order an MRI scan to test whether a prolactinoma tumor causes an increase in your prolactin levels. Your health care provider should prescribe medication to shrink any potential tumor.
There’s sometimes no specific cause for your high levels of prolactin. This is known as hyperprolactinemia which is idiopathic. This usually goes away after several months without medication. If your levels of prolactin are not going down, your doctor will probably prescribe medication.
You may get pregnant while you are receiving treatment for high levels of prolactin. If this happens immediately tell your doctor or endocrinologist. They could tell you to stop taking the medicine. Do not quit taking your medication until it is told you to do so, however.
Prolactinoma and hyperprolactinemia do not pose life-threats. Upon diagnosis, the worst side effects of medication usually go away. Once the prolactin levels return to normal, infertility caused by high levels of prolactin can be reversed. Even if you need long term treatment, the quality of life will remain high.