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Hyperprolactinemia & Lactation

Hyperprolactinemia is one of causes of dysfunction of the menstrual cycle.

What is hyperprolactinemia ?

Prolactin is a hormone produced by the pituitary gland, which lies under the brain in the skull. Increased levels of prolactin will occur for several reasons. They occur naturally in pregnancy and lactation but will also be raised in stress. This hormone stimulates lactation in women and its presence in concentrations higher than normal in non-lactating women is termed as “hyperprolactinemia”. Excess of the hormone prolactin can also lead to metabolic imbalances.

Hyperprolactinemia – causes

High prolactin levels in the blood in non-lactating women may be due to several factors:

  • The prolactin producing cells in the pituitary may be hyperactive;
  • Certain drugs such as tranquilizers, oestrogens (including oestrogens in birth control pills), pain killers and alcohol may cause a rise in prolactin levels;
  • Stress also induces hyperprolactinemia;
  • Certain diseases – raised prolactin may be due to liver or kidney disease, ovarian disease such as polycystic ovary syndrome (PCOS);
  • A rare type of endocrine tumor in the pituitary gland – “prolactin” producing cells in the pituitary form a cluster – a non cancerous tumour resulting in excess production of prolactin. In cases of very high concentrations of prolactin in non-lactating women, a computed tomography scan needs to be carried out to exclude the pituitary adenoma.

Hyperprolactinemia – symptoms

Lactation abnormal

  • Amenorrhea (absence of the menstrual cycles and periods);
  • Galactorrhea (lactation in non-pregnant and non-breastfeeding women);
  • Menstrual disorders (rare cycles, irregular cycles);
  • Decreased libido (decreased sexual needs);
  • Osteoporosis (lack of calcium in bones).

Hyperprolactinemia and fertility

Lactating women do not ovulate. Therefore women with hyperprolactinemia also have ovulatory disorders and following infertility.

Hyperprolactinemia – treatment

Hyperprolactinemia is best treated with a drug called ergo-bromocriptine. The dose of the drug is adjusted depending upon “how high” the levels of prolactin are. Regular intake of the drug will result in the drop in prolactin levels and normal ovulation. These women may either ovulate on their own or may need ovulation inducing drugs. It is strongly recommended for women with very high prolactin levels to seek the advice of a neurologist.

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