1 min 18 sec
Hormonal disorders
High prolactin and prolactinoma
Short answer
Prolactin is a hormone released by the anterior pituitary gland of the brain. The hormone dopamine keeps its release under control. High prolactin can have physiological causes (pregnancy, lactation, physical strain) or pathological ones; in pathological cases, prolactinoma is considered first. The doctor stresses that not every high prolactin level is treated. First, it is checked whether the patient's complaint is caused by high prolactin alone (video).
Schematic illustration
General information
- Causes:
- Physiological: pregnancy, lactation, physical strain.
- Pathological:
- first of all, prolactinoma — a prolactin-secreting tumor of the pituitary that is benign in most cases;
- chronic kidney and liver diseases;
- some medications (antipsychotics, antidepressants);
- a shortage of thyroid hormones (hypothyroidism);
- long-term stress, insomnia, even heavy exercise.
- Symptoms:
- In women: late or completely absent periods (amenorrhea), milk discharge without pregnancy, difficulty getting pregnant.
- In men: reduced sex drive, impotence.
- In a large prolactinoma: headaches.
- Normal values. Up to about 20 ng/mL in men and up to 25 ng/mL in women (depends on the laboratory). A level above normal is called hyperprolactinemia.
- Taking the test correctly. The test should be done at least 2 hours after waking up and in a stress-free state. Otherwise, the test has to be taken and assessed by a different method.
- Prolactinoma. By size, prolactinomas are classified as microprolactinoma, macroprolactinoma and large prolactinoma. Most are benign. They are identified by an MRI of the pituitary.
- Treatment. Special medicines that regulate hormonal control are used. Prolactinoma is often treated with medication. If prolactin is high, then, if needed, a pituitary MRI, thyroid tests and other causes should be looked into.
Q&A
My prolactin is a little high. Do I need to take medication?
Not every high prolactin level is treated. First, it is checked whether the test was taken correctly and whether the complaint is caused by prolactin alone. After that, specific treatment is recommended for prolactinoma or for high prolactin (video).
The doctor’s videos
The videos are in Azerbaijani.