Increased prolactin in men: symptoms, causes, consequences
The content of the article:
- The action of prolactin in the body of a man
- Causes of elevated prolactin in men and risk factors
- Symptoms of elevated prolactin in men
- Diagnosis of hyperprolactinemia
- Treatment of elevated prolactin in men
Prolactin (lactogenic, lactotropic or mammotropic hormone, mammotropin, LTH) is a peptide hormone secreted by acidophilic cells of the anterior pituitary gland. Has a pronounced level of daily secretion. Its main function is to provide lactation in women, but the hormone is also produced by the male body. Normally, the content of prolactin in the blood in men is 53-360 mU / l (2.5-17 ng / ml).
Increased prolactin in men leads to suppression of testosterone production
An excessively high level of LTH in the blood is called hyperprolactinemia. Hyperprolactinemia in men leads to the development of gynecomastia, decreased sexual activity, infertility, and impaired carbohydrate metabolism.
The action of prolactin in the body of a man
Prolactin receptors are located in the mammary glands, lungs, heart, liver, thymus, spleen, kidneys, pancreas, adrenal glands, testes, skeletal muscles, skin, and also in the central nervous system. The action of the hormone in a man's body is diverse:
- Reduces testosterone levels. There is an inverse relationship between these two hormones, which means that the higher the prolactin content, the lower the testosterone.
- Has some analgesic effect. In experiments on animals, it was found that a decrease in the level of LTH with the help of drugs leads to an increase in pain sensitivity and, conversely, its increase contributes to a decrease in the pain threshold. Perhaps one of the mechanisms of the analgesic effect of narcotic analgesics (morphine, Promedol, Omnopon) is their ability to increase the secretion of prolactin by the pituitary gland.
- Regulates sexual intercourse. Prolactin reduces the action of dopamine, which is responsible for sexual arousal. Most likely, he is responsible for the refractory period (the period immediately after the end of intercourse, during which sexual arousal cannot be caused).
- Participation in immune processes. Prolactin receptors are found on the membranes of cells that provide immune responses.
- Stimulation of the development of primary oligodendrocytes. These cells, while developing, turn into oligodendrocytes, which are responsible for the formation of myelin, a substance that is the basis of the myelin sheath covering nerve fibers.
Causes of elevated prolactin in men and risk factors
The maximum secretion of prolactin by cells of the anterior pituitary gland occurs in the early morning or REM sleep. A short-term increase in hormone production occurs under the influence of food intake, physical activity, stress, and a long-term one is caused by diseases. The most common cause of elevated prolactin in men is a pituitary tumor.
A high level of LTH is characteristic of the following diseases and conditions:
- hypothyroidism (insufficient secretion of thyroid hormones);
- chronic renal failure;
- cirrhosis of the liver with chronic hepatic failure;
- vitamin B 6 deficiency;
- autoimmune diseases (systemic lupus erythematosus, diffuse toxic goiter, rheumatoid arthritis, etc.);
- drug addiction (cocainism, morphinism);
- long-term use of certain medications (antihypertensive drugs, antidepressants, dopamine blockers).
A short-term increase in the level of LTH in the blood has no negative consequences and does not require correction. A slight increase in the level of the hormone (no more than 10-15%) is usually functional in nature, has no clinical manifestations and can only be detected by laboratory blood tests. Caused by the influence of the following factors:
- sleep disorders;
- significant physical activity less than 24 hours before the test;
- fasting for more than 12 hours before taking blood;
- psychological stress, including fear of "white coats";
- smoking;
- taking a significant amount of protein food the day before the test;
- chronic pain syndrome.
Symptoms of elevated prolactin in men
Symptoms of elevated prolactin appear and increase gradually, which is why the onset of hyperprolactinemia often goes unnoticed by the patient. Her signs:
- increased appetite with previous loads, weight gain;
- persistent headaches;
- sleep disorders;
- acne breakouts;
- decreased libido up to the complete absence of sexual desire;
- decreased potency;
- depressive conditions;
- severe general weakness;
- galactorrhea;
- gynecomastia.
The consequences of increased prolactin can be serious for the male body. Long-term hyperprolactinemia leads to infertility, the development of diabetes mellitus, osteoporosis.
Obesity in men is often a sign of hyperprolactinemia.
Diagnosis of hyperprolactinemia
Indications for a blood test for LTG are usually male infertility, erectile dysfunction, obesity, and gynecomastia.
A once-revealed increased level of prolactin in men is not a reason to talk about hyperprolactinemia. To exclude the influence on the result of random factors (for example, stress, excessive physical activity), the analysis is repeated twice more. In cases where hyperprolactinemia in a man is confirmed, a medical examination is performed to establish its cause. It includes the following methods:
- computed and / or magnetic resonance imaging of the skull - allows you to identify possible pituitary tumors;
- biochemical blood test - detects possible violations of the functions of the liver, pancreas, kidneys (changes in the level of bilirubin, creatinine, urea, glucose are detected);
- a study of the hormonal profile - includes the determination of the level of luteinizing, follicle-stimulating, somatotropic, adrenocorticotropic, thyroid-stimulating hormones, as well as thyroxine and triiodothyronine.
If there are indications, an additional spermogram, ultrasound of the thyroid gland and abdominal organs, ophthalmological examination (with the definition of visual fields), etc. are prescribed.
Treatment of elevated prolactin in men
The tactics of treating hyperprolactinemia in men is determined by the underlying cause of the disease. If a pituitary adenoma (prolactinoma) is detected, drug therapy with bromocriptine or cabergoline is performed, aimed at reducing the secretion of prolactin, as well as reducing tumor formation.
With the ineffectiveness of drug therapy or the presence of complications from the organ of vision, they decide on the surgical removal of the pituitary adenoma, and in case of impossibility of the operation, on the conduct of radiotherapy.
Increased prolactin in men, developed against the background of other diseases (drug addiction, renal or liver failure), requires treatment of the underlying pathology by doctors of the appropriate profile.
Folk remedies can be used only in cases where an increase in prolactin in men is caused by chronic stress, however, such situations require consultation with an endocrinologist. The doctor may recommend collecting medicinal plants with a sedative effect (lemon balm, valerian, peppermint, hops, etc.).
Medicinal plants with sedative effects can be used to treat stress-induced hyperprolactinemia in men
Attempts to treat the pituitary adenoma with folk methods (homemade preparations of the bug, hemlock, etc.) are not only ineffective, but also very dangerous, since the plants used for these purposes are poisonous and can cause severe intoxication, up to death.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
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