Prolactin (PRL) among the 6 female sex hormones is relatively stable and does not change significantly throughout the menstrual cycle. If prolactin rises above a certain value, it can cause various problems. In men, it mainly manifests as impotence; in women, it manifests as menstrual irregularities, galactorrhea and infertility. In medicine, excessive prolactin is called hyperprolactinemia, also known as galactorrhea-amenorrhea syndrome.
When you find that your luteal corpus function is insufficient, you have anovulatory menstruation, oligomenorrhea, or amenorrhea, and you squeeze both breasts hard at the same time, and you have galactorrhea, you should be highly suspicious of your prolactin level. If it exceeds the standard,
you should go to the hospital to check your hormone levels.
If prolactin exceeds 30ng/ml, it can be considered that prolactin exceeds the standard. Some hospitals set the standard at 25ng/ml. Since prolactin is affected by many factors, such as physical activity, sleep, meals, or emotional stress, the first test finds that it exceeds the standard. However, if it does not exceed the standard for a long time, it can be rechecked. Generally, blood is taken around 10 a.m. to determine the maximum value. can reflect the true level.
When you get the hormone test report, you should first pay attention to whether prolactin exceeds the standard. When prolactin is within the normal range, then look at other hormones; if prolactin is found to be high, other hormones are usually not normal. .
The elevated levels of prolactin have an inhibitory effect on the hypothalamic gonadotropin-releasing hormone, resulting in a decrease in pituitary gonadotropin levels, thus keeping follicle-stimulating hormone (FSH) and luteinizing hormone (LH) at normal levels. Low limit or lower than normal levels, leading to obstruction of follicle development, thereby reducing hormone synthesis in the ovary. The final result must be low estrogen levels.
There are many reasons for elevated prolactin, the most important and common of which is pituitary prolactinoma. Tumors with a diameter of more than 1 cm are called macroadenomas; tumors with a diameter of less than 1 cm are called microadenomas. tumor. Pituitary prolactinoma accounts for 1/3 to 1/2 of patients. When the prolactin in the patient\’s serum is >75ng/ml, this is a highly suspected cause; when the prolactin is >100ng/ml, the patient\’s probability of pituitary tumor is 57%; when the prolactin is >160ng/ml, the probability of pituitary tumor is 57%. It may increase to 89%. When the serum prolactin is >300ng/ml, almost 100% of patients have pituitary tumors!
In addition to pituitary prolactinoma, other hypothalamic pituitary tumors or diseases (including vacuolated sella turcica), hypothyroidism; kidney disease, certain medications (Medications that affect dopamine receptors and dopamine production) and even hypothalamic dysfunction of no known cause can increase prolactin. Therefore, it is necessary to find out the cause before taking appropriate measures.
The increase in prolactin is caused by the obstruction of the production and transport of dopamine, the prolactin inhibitory factor (PIF), causing the pituitary prolactin cells to lose their inhibitory control. Pituitary prolactin cells are the source of prolactin production, and dopamine produced by hypothalamic neurons enters the pituitary portal vein through nerve endings to exert inhibitory control on pituitary prolactin cells to maintain prolactin at normal levels. Therefore, dopamine is equivalent to a dam that regulates the water volume in the reservoir, and its effect is quite large.
Hyperprolactinemia should be treated appropriately: if it is caused by taking medicine, the symptoms will disappear on their own after stopping the medicine; if it is caused by hypothyroidism, renal insufficiency or intracranial lesions, corresponding medical and surgical treatment should be taken The method is to actively treat the primary disease; in addition to the above causes, almost all patients with idiopathic hyperprolactinemia and pituitary prolactinoma can be treated with \”bromocriptine\”.
\”Bromecriptine\” is the drug of choice for sudden hyperprolactinemia. It acts directly on the pituitary gland, inhibits the proliferation of prolactin cells, shrinks pituitary tumors, and stimulates dopamine receptors in the central nervous system. body, reducing the conversion of dopamine in the body and promoting the metabolism of prolactin. Therefore, it is very effective for hyperprolactinemia.
After taking \”bromocriptine\” for 1 week, the serum prolactin concentration can decrease; after taking the medicine for 2 weeks, the general galactorrhea can be resolved; after taking the medicine for 4 weeks, 95% of amenorrhea patients can resume menstruation. , 90% of patients can recover their ovulatory function; when the symptoms of galactorrhea and amenorrhea disappear and the serum prolactin concentration drops, the dosage of Oligopsin can be reduced, but please do not stop the medicine immediately. Sudden withdrawal may cause rebound!
Some sisters are not used to bromocriptine and have severe reactions after taking it, with constant nausea and vomiting. At this time, the method of administration should be changed, and \”bromocriptine\” can be inserted deep into the vagina. Since the epithelium of the reproductive tract comes from the paramesonephric duct, it has good absorption of drugs, and the acidic conditions of the vagina are conducive to absorption. Therefore, 99% of vaginal administration enters the systemic blood circulation, avoiding direct metabolism through the liver, and can better The effect of the drug also significantly reduced gastrointestinal reactions.
In addition to \”bromocriptine\”, other effective drugs include levodopa and vitamin B6. Levodopa is metabolized into dopamine in the body, and dopamine acts directly on the pituitary gland to reduce prolactin levels and relieve symptoms. Vitamin B6 acts as a coenzyme, increasing the conversion rate of dopa to dopamine in the hypothalamus, thus inhibiting the secretion of pituitary prolactin cells. It’s just that the dosage of vitamin B6 needs to be larger, and it needs to be taken for a longer period of time to be effective.
After prolactin is reduced, theoretically, the endocrine system will return to normal. However, due to great individual differences, the time to return to normal ovulation function may vary. During the treatment of patients with high prolactin, if it is found that the ovulation function does not recover quickly or the luteal function is insufficient, theWhen you are pregnant, you should use drugs to promote ovulation in time to try to get pregnant as soon as possible.
This article is provided by Baidu Reading and is excerpted from \”Pregnancy Can Be Simple\” Author: Feifei Mom