Hormone prolactin: the norm in women and men
The content of the article:
- Hormone rate
- Decreased hormone levels
- Increased hormone levels
- Determination of hormone levels
- How to normalize prolactin levels
Prolactin is one of the peptide hormones of the pituitary gland. Under the influence of the hypothalamus, it is secreted by acidophilic cells of the anterior pituitary gland, as well as, to a lesser extent, by the mammary gland, placenta, and lymphocytes. Almost all the effects of the hormone are associated with the reproductive function of the body, its main function is to ensure normal lactation after the birth of a child, but the hormone is produced in both sexes. Prolactin receptors are present in the uterus and ovaries, lungs, heart, kidneys and adrenal glands, liver and spleen, skeletal muscles, testes, and central nervous system. An increase in the concentration of the hormone in the blood plasma contributes to a decrease in testosterone or estrogen levels.
Prolactin is called the lactation hormone, since its main function is to prepare for lactation and provide it
Synonyms: lactotropin, mammotropin, mammotropic hormone, lactotropic hormone, lactogenic hormone, lactation hormone, LTG.
The main functions of prolactin in women:
- stimulates the growth and development of mammary glands in adolescent girls;
- regulates the increase in the number of lobules and ducts in the mammary glands;
- affects the processes of ovulation, the functioning of the corpus luteum;
- forms the maternal instinct;
- stimulates milk production after childbirth;
- increases the secretion of colostrum;
- regulates the process of converting colostrum into mature milk;
- is responsible for filling the gland with milk between feedings of the child;
- inhibits the effect of progesterone, estrogen, follicle-stimulating hormone after childbirth;
- controls water-salt metabolism.
In the male body, LTG (lactogenic hormone) controls the synthesis of proteins that bind sex hormones, increases the permeability of the seminiferous tubules for testosterone.
The main functions of prolactin in the body in men:
- regulates the growth of glandular tissue of the prostate;
- affects the change in body weight and the amount of adipose tissue;
- controls water-salt metabolism;
- regulates testosterone production;
- supports the development of secondary sexual characteristics;
- affects the condition and function of the vas deferens and seminal vesicles;
- regulates the process of spermatogenesis;
- forms libido.
Hormone rate
The production of prolactin is impulsive. Its fluctuations are influenced by many factors: stress, physical activity, sexual intercourse, food intake, the use of certain medications (hormonal contraceptives, antidepressants). The level of LTH in women changes according to the menstrual cycle. It is also influenced by the time of day and the phase of sleep: in the phase of short sleep, the maximum concentration of the hormone in the blood is recorded, a few hours after waking up, it decreases to minimum values. The norm for prolactin in non-pregnant women is 4.1–34 ng / ml.
During pregnancy, the amount of LTG increases dramatically, its level increases with each trimester. The increased secretion of the hormone prevents the production of progesterone, promotes the replacement of adipose tissue in the mammary glands with the glandular, provides an analgesic effect, reducing breast sensitivity and thereby preparing it for lactation. When the baby begins to suckle at the breast, receptors from the nipples transmit a signal to the hypothalamus, which stimulates the pituitary gland to produce prolactin. After childbirth and the beginning of lactation, the level of the hormone decreases slightly, but remains elevated for a long time relative to the pre-pregnancy level.
Norms of prolactin in pregnant women:
- up to 13 weeks - from 3.2 to 43 ng / ml;
- 13-27 weeks - from 13 to 166 ng / ml;
- 27-42 weeks - from 13 to 318 ng / ml.
The hormone rate in men is lower than that of women - 2.5-17 ng / ml.
Decreased hormone levels
An increase or decrease in the level of LTH may indicate serious disturbances in the functioning of the body.
Low prolactin levels are indicative of the following diseases or conditions:
- primary ovarian failure;
- true prolonged pregnancy;
- menopause;
- traumatic brain injury;
- Sheehan's syndrome (pituitary apoplexy);
- some tumors of the pituitary gland and brain;
- pituitary tuberculosis;
- radiation therapy.
Some drugs (including anticonvulsants or dopaminergic drugs) are capable of lowering the hormone level - calcitonin, conjugated estrogens, cyclosporin A, dexamethasone, dopamine, apomorphine, metoclopramide, morphine, nifedipine, rifampicin, secretin, bombesin, tamoxifen.
Symptoms indicating a low prolactin content:
- menstrual irregularities;
- decreased libido;
- anorgasmia;
- a decrease in the volume of breast milk or its complete absence after childbirth;
- inability to conceive;
- early spontaneous abortion;
- frequent headaches;
- dyspeptic disorders;
- swelling;
- dizziness;
- fluctuations in blood pressure;
- hyperhidrosis;
- nervousness, depression, obsessive fears and phobias;
- deterioration of vision, hearing, smell.
Often, hormone deficiency is asymptomatic.
Increased hormone levels
The reasons for an increase in the concentration of prolactin can be the following diseases:
- prolactinoma (a benign tumor of the pituitary gland);
- diseases of the hypothalamus (damage to the pituitary gland, glioma, germinoma);
- pseudotumor of the brain;
- myoma;
- polycystic ovary syndrome;
- endometriosis;
- arteriovenous defects;
- hypothyroidism;
- tuberculosis;
- cirrhosis of the liver;
- hepatic and / or renal failure;
- autoimmune diseases (rheumatoid arthritis, diffuse toxic goiter, systemic lupus erythematosus);
- operations and injuries in the chest area;
- hypovitaminosis B6;
- chronic prostatitis;
- taking certain medications (estrogens, prostaglandins, antipsychotics, antihypertensive and antihistamines, opiates, hormonal contraceptives, antidepressants).
Gynecomastia is a sign of increased prolactin in men.
If elevated LTH levels are not detected during pregnancy or lactation, reproductive disorders may occur.
Signs of increased prolactin:
- menstrual irregularities (from oligo- and opso- to amenorrhea);
- the development of the mammary glands in men according to the female type;
- cysts or adenomas of the mammary glands;
- galactorrhea (abnormal secretion of milk or colostrum);
- infertility;
- decreased libido, anorgasmia;
- atrophic changes in the vaginal mucosa;
- hirsutism (excess growth of hair on the body and face in women according to the male pattern);
- disorders of visual function;
- metabolic disorders (obesity, osteoporosis, hyperinsulinemia, arterial hypertension);
- inflammation of the sebaceous glands, acne;
- psycho-emotional disorders (depression, mood swings, anxiety);
- decreased facial hair growth, gynecomastia, erectile dysfunction, testicular atrophy, prostate disease in men.
Determination of hormone levels
For analysis for prolactin, blood is drawn from a vein. The day before the test, one should avoid physical and psychological stress, thermal procedures, refrain from sexual intercourse, drinking alcohol, and smoking.
To exclude the influence on the result of the daily fluctuation in the synthesis of the hormone, you need to donate blood in the morning, a few hours after waking up. In women, the study date is selected individually based on data on the menstrual cycle. Usually, the analysis is taken between 5 and 8 days of the cycle.
A single determination of the level of LTG has no diagnostic value; for the diagnosis, the average value of the determinations in three different days is used. If the level of the hormone is increased in at least two of the three results, additional studies are assigned:
- blood chemistry;
- X-ray of the skull, which allows you to assess the shape and size of the Turkish saddle (anatomical area of the pituitary gland);
- CT and MRI of the brain with a contrast agent (gadolinium) - allow you to visualize the outline and location of adenoma or other tumors located in soft tissue formations;
- assessment of the function of the thyroid gland (examination of the content of thyroid hormones in the blood and / or urine, ultrasound of the thyroid gland);
- Ultrasound of the pelvic organs, mammary glands, liver, kidneys;
- analysis for macroprolactin.
How to normalize prolactin levels
Therapy for low prolactin is aimed at stimulating the pituitary gland and increasing the sensitivity of prolactin receptors.
For disorders caused by high hormone levels, dopamine receptor agonists (Bromocriptine, Parlodel, Norprolak, Dostinex, Cabergoline) are prescribed, which suppress the secretion of the hormone and normalize its level in the blood within a few weeks after the start of treatment. In men, along with a decrease in the level of LTG, the content of androgens normalizes, and the spermogram improves. In women, the menstrual cycle, ovulation and the ability to conceive are restored.
If the violation of LTG synthesis is associated with prolactinoma, its therapy is carried out. If drug treatment is ineffective, prolactinoma continues to grow, its pressure on the nerves of the optic chiasm can lead to irreversible consequences for vision, up to blindness. Therefore, in case of ineffectiveness of drug therapy for prolactinoma, surgical intervention (adenectomy) or radiation is indicated. The latter method has side effects that can be delayed for several years, so it is not used to treat young women planning pregnancy. One of the main undesirable effects is the development of pituitary insufficiency. This condition is compensated for with hormone replacement therapy.
To monitor the effectiveness of treatment, the analysis is repeated every 30-60 days.
To normalize elevated prolactin, foods rich in folic acid must be introduced into the diet
The diet with elevated LTH should be enriched with folic acid, which stimulates hematopoiesis and testosterone production, increases estrogen levels, as well as the digestibility of protein foods, the excessive consumption of which is considered one of the reasons for the physiological increase in the hormone. Folic acid is found in liver, lean meat, fatty fish, chicken eggs, parsley leaves, spinach, vegetables, nuts, seeds, flax seeds. At the same time, the use of gluten-containing products is reduced, and it is advisable to completely abandon smoked meats and canned food.
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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