Increase in Milk Hormone (Hyperprolactinemia) prolactin in the body milk production It is the hormone that provides When a woman becomes pregnant, the hormones that rise stimulate prolactin to produce milk from the breasts.
In some women colostrum Early milk, called premature milk, can be secreted from the breasts during pregnancy, even before birth, and this is thought to be normal. Prolactin hormone is necessary for the development and function of female reproductive organs at certain levels even without pregnancy. This hormone is in the lower part of our brain. pituitary It is produced by some cells in the organ called and released into the blood. It is also secreted from the part of our brain called hypothalamus. dopamine It is kept under control by the release of another substance called
Prolactin hormone;
-During pregnancy,
-In tumors of the pituitary tissue called adenomas,
-In thyroid hormone disorders,
-Increases in estrogen hormone,
-In case of decreased secretion of the hormone called dopamine (such as tumors, some drugs and damage to the pituitary gland)
-In the use of some psychiatric or hypertension drugs,
-Excessive breast (nipple) stimulation,
It may increase, but sometimes no reason can be revealed. prolactin to the rise of the hormone hyperprolactinemia is called.
What happens in the body when the prolactin hormone increases (in case of hyperprolactinemia)?
-Menstrual irregularities (few menstrual periods, infrequent menstrual periods, absent menstrual cycles)
-Nipple discharge (milk discharge outside pregnancy = galactorrhea).
-Inability to become pregnant (infertility) may occur due to disruption of ovulation
The diagnosis of high prolactin is made by measuring the prolactin level in the blood.
However, some points should be taken into consideration when making this measurement:
-It should be examined between 10:00-11:00 in the morning,
-Do not have sexual intercourse on the morning of the test,
-Breast stimulation should be avoided for a few days before the test (tight bras should not be worn, breasts should not be rubbed even for washing),
-If possible, one should be hungry.
-The drugs used, especially psychiatric drugs, should be discontinued.
-It is important to be away from stress before taking a blood sample. If possible, it is useful to rest in a quiet place for 10-15 minutes and take a blood sample.
Women who apply with one or more of the complaints of menstrual irregularity, inability to get pregnant, or milk coming out of the breasts outside the breastfeeding period are asked to measure the prolactin hormone level in the blood. When the hormone level in a woman diagnosed with hyperprolactinemia is above a certain level (normal is usually 5-25 ngr/ml), these regions are usually examined with a method that images the hypothalamus and pituitary. The aim of this review is to pituitary adenoma It is to determine whether there is a benign pituitary tumor, which is the most common cause of hyperprolactinemia, and to investigate other rare conditions that may cause hyperprolactinemia in the region. As an imaging method, a simple sella turcica ("cella turcica") (anatomical area in the head where the pituitary gland is located)
Does high prolactin cause infertility?
One of the causes of infertility is excessive elevation of the prolactin hormone. However, infertility may not occur in everyone with high prolactin levels. As the prolactin hormone increases, deterioration is observed in the woman's ovulation function. This deterioration is directly proportional to the level of prolactin hormone. In other words, the higher the prolactin hormone, the more the ovulation functions will deteriorate and eventually there will be no amenorrhoea, cessation of menstruation Even a table may be formed. While menstrual irregularities are frequently detected in women with high blood prolactin, they may or may not be accompanied by complaints of milk discharge from the breasts. It is not always possible for the breast tissue of a woman who is not in the pregnancy period to respond to the high blood prolactin level with milk production. In contrast milk coming from breasts In women with complaints, prolactin hormone measurements can sometimes be found to be normal. The possible reason for this is the existence of some prolactin hormone subtypes that cannot be measured by today's classical laboratory methods but have strong milk-forming properties.
How is high prolactin treated?
hyperprolactinemia It responds well to drug treatment.
The use of medication is the most valid and healthy method in treatment. Hormone-specific drugs that control the production and release of prolactin hormone into the blood are used, and in most patients, the problem disappears with medication.
However, drug therapy is not an easy treatment due to side effects.
In some patients, it may cause problems such as dizziness, nausea and weakness, and low blood pressure, which decrease over time and disappear when the treatment is finished.
First of all, the cause that increases the prolactin level should be tried to be found and this cause should be treated.
complaint inability to conceive If the patient is diagnosed with high prolactin levels, drugs that lower the prolactin level and sometimes drugs that promote ovulation are used.
When the problem is milk coming from the breasts, medications that lower the prolactin level are used.
When the complaint is menstrual irregularity, drugs that lower the prolactin level can be used, but in a woman who does not want to have children, drugs that only eliminate the symptom, that is, regulate menstrual bleeding, can be used. birth control pill Medicines such as can also be used.
Treatment of Pituitary Adenoma
In person with imaging methods pituitary adenoma When benign tumors called tumors are detected, it is first investigated whether they cause pressure symptoms.
Adenomas good-natured They are tumors and are observed quite frequently, they do not tend to become cancerous and they generally grow slowly. In autopsies, pituitary adenoma can be found in 5% of women who are 70 years old and have no complaints.
Pituitary adenomas are smaller than one centimeter in diameter microadenoma, to the big ones macroadenoma Although its name is given, what is important is not the size of the adenoma but whether it puts pressure on the surrounding tissues and its growth and hormone secretion rate.
Although the degree of pressure exerted by the pituitary adenoma on the environment is usually clearly observed in the imaging method, it is used to investigate the presence of pressure on the optic nerve.visual field examination is also applied.
Most adenomas can be treated with prolactin-lowering drugs. Thus, operations are used very rarely. Surgery may be required, especially in adenomas that cause severe symptoms (severe headache, very narrow visual field) or tend to grow rapidly.
Today's opinion; If the woman has no complaints and hyperprolactinemia is detected incidentally, this is not important. Today, it is known that prolactin has different types of molecules and that prolactin levels that do not cause clinical complaints are largely due to inactive molecules and do not require treatment.