Prolactin (PRL) is a hormone secreted by the pituitary gland. If the blood content is too high, it is called hyperprolactinemia. In the late pregnancy and puerperium, lactogenic cells account for 20% to 40% of the anterior pituitary gland, and only 1% in other periods. The prolactin level in full-term pregnancy can reach 200 micrograms/liter to promote the formation of milk. In the non-pregnancy and puerperium period, the serum prolactin of women of normal childbearing age should be below 30 micrograms/liter. If it exceeds 30 micrograms/liter, it is considered to be high lactation. Acidemia, exceeding 50 μg/L, should be treated.
The main clinical manifestations of hyperprolactinemia are:
(1) Infertility:High prolactin acts on the pituitary gland, inhibiting follicle-stimulating hormone and luteal body Secretion of genitin. The follicle-stimulating hormone is too low to mature the follicles, and the luteinizing hormone is too low to cause a luteinizing hormone peak, so ovulation does not occur and infertility occurs. When the blood prolactin concentration increases, the prolactin level in the follicular fluid also increases, the estrogen level decreases, the granulosa cells decrease significantly, and the secretion of progesterone decreases, causing luteal insufficiency and leading to infertility or early pregnancy miscarriage.
(2) Oligomenorrhea or amenorrhea: Initial menstruation may be normal, and gradually change to oligomenorrhea or even amenorrhea. Characteristics of amenorrhea: The level of luteinizing hormone is low, normal fluctuations disappear, resulting in anovulation, estrogen cannot cause positive feedback, there is no peak of luteinizing hormone, and it does not respond to clomiphene.
(3) Lactation: Non-postpartum lactation is a sign of hyperprolactinemia, accounting for about 1/3 to 2/3 of hyperprolactinemia. About 30% of cases are not accompanied by elevated prolactin and coexist with amenorrhea, which is often called amenorrhea lactation syndrome. If high prolactin, amenorrhea, and lactation coexist, 2/3 of the cases will have pituitary tumors.
(4) Others: If there is a pituitary gland tumor, it can cause headaches, vision loss and visual field defects. Due to low estrogen levels, symptoms such as decreased libido, vaginal dryness, dyspareunia, and smaller breasts may occur.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao