Hyperprolactinemia, a type of disease that occurs when levels of the hormone prolactin in the body are above normal, can lead to symptoms such as irregular menstrual cycles or absence of menstrual cycles, infertility or milk production from the breasts without pregnancy. The hormone prolactin, known as the milk hormone and essential for the development and function of female reproductive organs, should generally be below 25 ng/ml in a healthy woman. An elevated level of the hormone above this level can lead to a decrease in the menstrual cycle or absence of menstruation (amenorrhea), and the inability to conceive despite wanting pregnancy and not using contraception.
Causes of Hyperprolactinemia
Some of the reasons that lead to elevated prolactin hormone causing hyperprolactinemia are as follows:
- Pregnancy and lactation
- Tumors and injuries of the hypothalamus that reduce dopamine release
- Birth control pills containing estrogen
- Benign tumors such as prolactinoma
- Hypothyroidism, elevated TRH hormone
- Some of the drugs used in psychiatry (antidepressants and antipsychotics)
- Other pharmacological drugs (especially metpamide-derived antiemetics – i.e. anti-nausea drugs)
- Having an orgasm
- Excessive stress
- Kidney failure
- Liver cirrhosis
Symptoms of Hyperprolactinemia
The presence of hyperprolactinemia can lead to various symptoms in the body. Symptoms such as irregular menstruation or changes in ovulation, headaches, fatigue, weakness, loss of appetite, lack of energy, depression are symptoms that may indicate elevated prolactin levels. In addition, symptoms such as impaired vision or blurred vision, osteoporosis, decreased sexual desire, vaginal dryness, dyspareunia (painful sexual intercourse) due to vaginal dryness, infertility, galactorrhea, weight gain are among the symptoms of hyperprolactinemia.
Diagnosis and Treatment of Hyperprolactinemia
Patients presenting with the above symptoms are tested for the hormone prolactin in the blood. With this test, the patient’s prolactin hormone level is examined to see how much higher the level is than normal. It is ideal to perform the test during menstruation. However, the patient is requested to have the test in the morning, to stop sexual intercourse 2-3 days before the test and to avoid breast stimulation. If the patient’s hormone levels are high as a result of the test, advanced imaging methods such as a pituitary X-ray (cella spot X-ray), CT (computed tomography) or MRI (magnetic resonance imaging) of the pituitary gland are performed.
Treatment of hyperlactinemia is planned according to the cause of elevated prolactin levels. Treatment is usually with medication to lower prolactin levels, but in very large lesions, the patient may undergo surgery.