Prolactin Testing

Elevated levels of prolactin can interfere with a woman's menstrual cycle. Prolactin is a hormone associated with pregnancy and breastfeeding. Levels of this hormone will increase during pregnancy in order to stimulate the mammary glands to produce milk for a baby (lactation).

Hyperprolactinemia is a condition in which the body produces higher levels prolactin.
Hyperprolactineamia is associated with anovulatory infertility, oligomenorrhoea, amenorrhoea, hypoestrogenism, unexpected lactation and the loss of libido in women. It's also associated with erectile dysfunction and a loss of libido in men.
Hyperprolactinemia is diagnosed when prolactin levels are in excess of 25 µg/L for women, and 20 µg/L for men. However prolactin levels will vary depending on age, gender, menstrual cycle stage and pregnancy.

Hyperprolactinemia can happen for a number of reasons:

  • Prolactinomas (a prolactin-producing pituitary tumour)
  • Medications that interfere with dopamine levels e.g. phenothiazines, metoclopramide, risperidone, selective serotonin reuptake inhibitors. Also estrogens and verapamil, a medication for high blood pressure.
  • Stress
  • Pregnancy
  • Hypothyroidism
  • Kidney disease
  • Chest trauma

Hyperprolactinemia is most frequently caused by a benign pituitary tumour called a prolactinoma. These can disrupt the hypothalmic-pituitatry-gonadal axis by suppressing GnRH (gonadotropin-releasing hormone) which controls the release of FSH (Follicle-stimulating hormone) and LH (Luteinizing hormone), two important menstrual cycle hormones.. Read more→

Drugs are available for the treatment of hyperprolactinemia. These include; Parlodel® (bromocriptine), Dostinex® (cabergoline) and Norprolac® (quinagolide).
These drugs effectively lower prolactin levels and reduce tumour size in over 90% of patients. Once treatment begins, prolactin levels typically normalize within days and tumour shrinkage is seen within 3-6 months.
Cabergoline is more effective at lowering prolactin levels with fewer side effects (headaches). However bromocriptine is less expensive, but side effects include nausea, low blood pressure, and dizziness.

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