Our human bodies are guided by an intricate system of hormones, chemical messengers that control virtually all our human physiology, including metabolism and growth, sexual activity and mood. One of these, however, lesser known, is the prolactin hormone, which has a seemingly general and crucial role in health maintenance.

The role of prolactin is commonly linked with breastfeeding, but its effects go much further to other aspects. It affects the sexual health, sexual performance, immune system and even mental health in females and males. Upon abnormal levels, due to their high or low values, they can force bodily systems to work abnormally and indicate conditions that should be addressed by medical care.

This article examines the meaning of prolactin, its functioning and the normal level of prolactin and then what happens when the levels have gone past the normal range.

What is Prolactin?

Prolactin is a hormone which is a type of peptide and majorly produced by the anterior pituitary gland which is a bit sized organ situated at the bottom of the brain. Although the name prolactin is based on the fact that it stimulates milk production (pro-lactation), not all functions of prolactin are limited to lactation.

Actually, Prolactin receptors exist in several tissues in the entire body, the brain, reproductive organs, adrenal glands, and the immune system. The broad receptor distribution is indicative of the fact that prolactin has a role in:

• Modulation of reproduction Phenomenon
• Immune response control
• Fluid balance Maintenance of fluid balance
• Mammary gland developments
• Pregnant phenomena Discoveries

The hypothalamus regulates the production of prolactin, mostly by the means of dopamine, a prolactin-inhibiting factor. With a reduction in dopamine, prolactin is also increased and vice versa.

Normal Amount of Prolactin

The amount of prolactin in the blood is determined as nanograms per milliliter (ng/mL). The normal range can be slightly different, depending on the laboratory and method in which the test is made and also depending on age, sex and physiological state of the patient (e.g. pregnant or menopausal).

Reference Ranges:

These are just a guiding principle. Differences in test kits and methods of assay sometimes produce some slight variations in normal lab-to-lab ranges. We should also understand the levels of prolactin with situations of other clinical results.

What Causes High Prolactin? (Hyperprolactinemia)

Hyperprolactinemia exists when the levels of prolactin are above the common levels. Although it is more prevalent in females, it may affect people regardless of gender. Increased prolactin may be caused by many physiological, pathological and pharmacological means.

Most Frequent Reasons of High Prolactin:

1. Pituitary Tumors ( Prolactinomas):

• Most frequently it is caused by benign tumors of the pituitary.
• These are tumors that release surplus prolactin and they may also push other tissues and upset vision or lead to the occurrence of a headache.

2. Medications:

There are drugs that disturb dopamine and elevate the amount of prolactin which includes:

• Antipsychotics (risperidone, haloperidol etc)
• Antidepressants (SSRI, tricyclics)
• Drugs to control blood pressure (e.g. verapamil)
• Antiemetic medications (e.g. metoclopramide)

Hypothyroidism:

• The micro level of the thyroid hormone results in a rise in the secretion of the thyotropin releasing-hormone (TRH) which may rescue prolactin.

4. Syndrome of stress and physical exertion:

• Temporary increases in prolactin level may result due to acute emotional stress, intense exercise or even sleep.

5. Chest wall Stimulation:

• Injury to the chest nerves through trauma and surgery or herpes zoster may stimulate the increase of prolactin.

6. Lactation and Pregnancy:

• Naturally found with very high concentration of prolactin.

Side Effects of High Prolactin Levels

High levels of prolactin may produce numerous symptoms and many of them are associated with the way it affects sex hormones such as estrogen and testosterone.

In Women:

• Aberrant or missing period (amenorrhea)
• Infertility
• Galactorrhea (secreting the milk out of the nipples and not during the process of breastfeeding)
• Intercourse pain because of low estrogen
• Feelings of exhaustion, changes in mood

In Men:

• Reduced libido
• Erectile dysfunction
• Infertility
• The increase of the breast (gynecomastia)
• Muscle weakness
• Reduced facial or hair loss on the body

In Both Sexes:

• Reduced calcium density (osteoporosis)
• Collection problems (when there is a pituitary tumor that is pushing on the optic chiasm)
• Headaches

As a result of the chronic hyperprolactinemia, in case of the failure to treat it, the reproductive process may fail, the hormonal equilibrium may be disturbed and permanent metabolic problems may occur.

What Are The Low Levels Of Prolactin?

Low, but less frequently observed prolactin levels also may be clinically important. This state is termed as hyperprolactinemia and is the general indicator of the pituitary dysfunction or the hyperactivity of dopaminergic agents.

Possible Causes of Low Prolactin:

1. Pituitary injury or Tumor:

• Production of prolactin may be interfered with by trauma, surgery, radiation or tumors.

2. Dopamine Overproduction:

• Surplus dopamine or by means of a dopamine agonist drug (e.g. bromocriptine, cabergoline) represses the prolactin spill.

3. Autoimmune Hypophysitis:

• Rare inflammation of the pituitary which lessens the secretion of hormones.

4. Sheehan’s Syndrome:

• Postpartum pituitary infarction resulting in multiple pituitary hormone insufficiencies, caused by extreme blood loss during childbirth.

Low Prolactin Symptoms:

1. Breastfeeding Women: Inability or difficulty to produce breast milk.
2. Others: It is frequently asymptomatic, though it can be associated with:

• Fatigue
• Low mood
• Decreased immune defense (potential hypothetical connections)

Minor prolactin levels outside lactation remain unclear with regards to their clinical implications. It is not a major concern unless it is related to more encompassing deficiencies of pituitary hormones.

What Is The Measurement Of Prolactin?

The prolactin blood test:

Prolactin test is quite easy to perform, a blood drawing in a hospital. The test is best when performed in the morning and this is normally between 8:00 AM and 10:00 AM because at this time, prolactin is higher in wakefulness.

Pre-Test Guidelines:

• It is best to avoid stress, strenuous exercise and sexual contacts at least 24 hours before the test.
• Abstain yourself of any other food or beverage (except water) at least 8 hours (as recommended by your doctor).
• Tell your doctor what drugs you are taking.

Follow-up Testing:

When your prolactin is elevated and low:

• Your physician can further test so as to disregard short term changes.
• Additional studies can be carried out:
• Brain MRI (in order to identify pituitary tumors)
• Tests of the function of the thyroid gland (exclusion of hypothyroidism)
• Additional pituitary hormone assays

Treatment and Ways of Control

Treatment of abnormal prolactin levels The treatment of abnormal prolactin levels is dependent upon the cause and upon the degree of symptoms.

In The Case of High Prolactin (Hyperprolactinemia):

1. Dopamine Agonists:

• The first-line medications are such drugs as bromocriptine and cabergoline, which reduce prolactin production thanks to their stimulating effect on dopamine receptors.
• It can be very useful in reducing pituitary tumors and in re-establishing fertility.

2. Thyroid Hormone Replacement:

• In case of its cause by hypothyroidism, the problem can be rectified with the help of levothyroxine.

3. Surgical or Radiologic Intervention
   

• When tumors are non-responsive to the medication or they are producing the symptoms of compression.

4. Medication Adjustment:

• In case a given drug prescribed to a patient is increasing prolactin, substitutes can be given under doctor care.

In The Case of Low Prolactin (Hypoprolactinemia):

• It does not usually need treatment unless it interferes with breastfeeding or is a sign of general dysfunction of the pituitary.

• Domperidone can be administered, at medical advice, in lactating women with insufficient milk supply so as to boost their prolactin levels.

Significance of Monitoring Prolactin

Hormonal well-being is not a vacuumed term, it is also concerned with reproductive well being, clear thinking, strong bones, as well as immune response. The prolactin is particularly significant where there is monitoring of:

• Women who had irregularities of the menstruation period or infertilities
• Unexplained sexual dysfunction among men
• Patients having pituitary tumors or neurological manifestations
• Women with problems in lactation after childbirth

Timely detection and specific treatment would avoid complications and increase the quality of life.

Final Thoughts

The potent hormone is prolactin which has wide reaching effects. This factor might not attract as much attention as estrogen and testosterone, and yet, when the prolactin is out of the balance, it can seriously mess with your reproductive, emotional, and general health.

A prolactin test is also an important diagnostic procedure whether you are trying to conceive, experiencing symptoms of unexplained disorders, or having your test run to determine a pituitary disorder. Unusual findings cannot be overlooked because a majority of reasons can be dealt with accordingly.

When you notice that you have any of the symptoms that allergic reactions can indicate the presence of a hormonal disturbance, you would need to consult a medical expert to evaluate the need to conduct a prolactin test.