You may have heard about hormones but how much do you really understand how hormones work in general? Hormones are chemicals produced by cells, typically the endocrine gland. Hormones are released into the bloodstream before they reach the targeted organ or part of the body. Do you know that hormones are powerful because they can control a lot of body function despite in miniscule amount? In the world of medicine, imbalance hormones can be a great concern such as high prolactin.
What is prolactin? Prolactin is a hormone in the body which is produced by the pituitary gland. Specifically, it is produced by the lactotroph cells located in the front part of the pituitary gland (anterior pituitary gland). This hormone can be found both in men and women. Prolactin is most famous for its responsibility in producing milk for the young after birth and breast development during pregnancy. However, there are over 300 functions of prolactin in the body.
Prolactin is regulated by the brain chemicals known as neurotransmitters. Neurotransmitters such as dopamine and oestrogen are shown to be the most influential chemicals to affect prolactin. Apart from the two hormones, other hormones such as oxytocin, antidiuretic hormone and thyrotropin releasing hormone. The amount of prolactin released in the body will depend on the amount of hormones that regulates it.
When the amount of prolactin is too high in blood, it is known as hyperprolactinemia. This condition is considered abnormal in men and women who are not pregnant. The issue with hyperprolactinemia is it interferes with the normal production of other hormones such as oestrogen and progesterone. When this condition occurs in women, it causes menstrual problems such as stopping ovulation which then eventually lead to irregular or missed periods. Hyperprolactinemia in men can cause abnormal lactation (galactorrhoea), low sex drive and even infertility.
There are many causes for hyperprolactinemia. Common one is pituitary tumour known as prolactinomas. The level of prolactin correlates well with the size of the prolactinomas. Prolactinomas are typically benign or non-cancerous but can cause damage to the surrounding tissues if left untreated. Other causes are hypothyroidism, certain medications used in treating mood disorders or hypertension, immense stress, excessive exercise, lesions on the chest wall such as from burns, surgeries and herpes zoster, and certain herbs such as fennel seeds and fenugreek. It is reported that around a third of all cases of hyperprolactinemia, the causes remain unknown.
Symptoms will depend on the underlying cause. For example, when it is caused by hypothyroidism, symptoms such as fatigue, muscle pain, constipation, sensitivity towards cold environments and weight gain, are among symptoms that can be found alongside the hyperprolactinemia. Hyperprolactinemia in women who have yet to be in menopause will cause symptoms such as irregular periods, infertility and premature menopause (period stops before the age of 40).
The only way to know the level of prolactin is through a blood test. Blood tests may be done more than once to ensure that the readings are accurate and reflect the true amount of prolactin in the body. Besides blood tests, doctors may also perform physical examinations to check for the causes. Doctors may proceed with imaging tests such as MRI to check for mass in the pituitary gland. Review of medications and other medical conditions associated with hyperprolactinemia will be done by a doctor to check for the possible causes.
Those affected with high prolactin may wonder if there is cure for the condition. This is especially true when patient are greatly affected by the condition or have symptoms. Yes, there is cure for high prolactin. Once the cause that leads to high levels of prolactin has been identified, treatment can be planned by a doctor. Treatment will depend on the causes and this will greatly vary depending on the severity of the issue.
Surgery is a choice of treatment for pituitary gland tumour. Surgery is offered when there is large tumour or symptoms affecting patient. Hypothyroidism is treated with thyroid replacement medicine. If medication is found to be the cause, doctor will advise different medicine or provide alternative. The aim of treatment is to ensure prolactin level decrease. Hyperprolactinemia is mostly treated with dopamine agonists such as cabergoline and bromocriptine.
It can be concluded that there is a cure for high prolactin. It may take time for prolactin to be in optimal range. It is important to get treated for hyperprolactinemia as to be left untreated, may cause symptoms to persist and even high chance for complications. Treatment depends on the cause. To find the cause, medical history and physical examination is done by a doctor. Blood tests and imaging tests are needed to confirm diagnosis and its causes. High level of prolactin should be a concern in men and women who are not in pregnancies. You should get medical advice whenever you have symptoms related to high prolactin.
