If elevated prolactin hormone ...

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  • What are the causes of hyperprolactinemia
  • How is the diagnosis of hyperprolactinemia
  • How is the treatment of hyperprolactinemia

  • Hyperprolactinemia - this increase in hormone levels
    prolactin. Typically, the prolactin level in the blood increases in
    Pregnancy and breast-feeding, which leads to the development of
    milk. As soon as a woman stops to feed the baby, the level of
    prolactin is reduced to normal. If prolactin levels increase not
    during pregnancy or is not reduced to normal after discontinuation
    breast feeding, then this condition is known as hyperprolactinemia.

    One symptom of hyperprolactinemia is
    irregular menstruation (infrequent menstruation or complete their
    absence), because elevated levels of prolactin violates the synthesis
    follicle stimulating hormone (FSH) and luteinizing hormone (LH),
    regulating the menstrual cycle. This is largely the cause
    infertility in women with hyperprolactinemia. Patients with
    hyperprolactinemia also may suffer from headaches, they can
    observed decreased libido.

    30% of women with elevated prolactin
    meets galactorrhoea (release of milk from the mammary glands).
    Occurrence galactorrhea depends on the level of the hormone. It does not
    is a manifestation of a breast disease, for example,
    cancer, and occurs because of the physiological effect of prolactin.

    Such violations, as hirsutism, hyperandrogenism
    (Increase the level of male sex hormones) and acne to occur in 20-25%
    patients with hyperprolactinemia.

    What are the causes of hyperprolactinemia

    There are many causes of pathological
    increasing blood levels of prolactin. Even a minimal stress
    before blood samples for the study as a pelvic examination or
    study of mammary glands may cause a momentary
    increase prolactin.

    hormone level may be increased due to the reception
    certain drugs, such as antiemetics,
    antipsychotics, estrogens, opiates, birth control pills. If
    when you study found increased blood levels of prolactin,
    be sure to tell your doctor about these drugs.

    hyperprolactinemia reason may be transferred
    radiation exposure, surgeries on the breast and
    the organs of the chest, a syndrome of "empty" sella (Turkish
    saddle - a bone formation at the base of the skull, in which
    It is the pituitary gland).

    The cause of elevated levels of prolactin can be
    and chronic liver failure and kidney failure
    thyroid function (hypothyroidism), and a number of other endocrine
    diseases (Cushing's disease, polycystic ovary syndrome).

    In addition to a variety of endocrine and not endocrine
    disease, hyperprolactinemia can be caused by benign
    tumors of the hypothalamic-pituitary region - pituitary adenoma,
    generating prolactin (prolactinoma). Adenomas grow very slowly
    or do not grow at all. What exactly is their education, yet to
    It is not clear.

    Mikroprolaktinomy (10 mm in diameter) and
    macroprolactinoma (10 mm in diameter) are a common cause
    hyperprolactinemia. Elevated prolactin levels are detected in 20-25%
    patients with infertility and various disorders of the menstrual cycle,
    and at 40-45% due to the presence of tumor hyperprolactinemia
    pituitary.

    It should be noted that quite often increased
    prolactin levels found in the absence of the above
    pathologies. This so-called "idiopathic" or "functional"
    form of hyperprolactinemia. Its reason lies in the increased function
    cells secreting prolactin.



    How is the diagnosis of hyperprolactinemia

    Hyperprolactinemia Diagnostics includes:

    • determining the level of prolactin and other hormones in the blood plasma;
    • kraniogramme (x-ray of the head);
    • X-ray computed tomography or nuclear magnetic resonance (NMR) imaging of the head;
    • research fundus and visual fields.

    If elevated prolactin hormone ...If it turns out the results of a blood test that
    elevated prolactin levels, and other manifestations of hyperprolactinemia not,
    it is necessary to repeat the analysis to exclude errors. Blood sampling for
    prolactin content analysis should be carried out from 9 to 12 am
    on an empty stomach. A woman should have a good rest, the day before to refrain from
    sexual intercourse.

    hyperprolactinemia Diagnosis can be made at
    double detected elevated levels of prolactin. For most
    Laboratory standards hormone upper limit - 500 mU / l or 25 ng / ml.
    Prolactin in some degree may indicate the reason
    hyperprolactinemia: the prolactin level greater than 200 ng / ml (4.000
    mU / l), there is usually a macroadenoma pituitary; in prolactin level
    less than 200 ng / ml (4000 IU / L) is the most likely diagnosis - microadenoma
    pituitary or idiopathic hyperprolactinemia.

    In addition to determining the level of prolactin, you must
    be sure to check the function of the thyroid gland, as well as to determine the
    levels of other hormones.

    It should also be made to render kraniogramme
    sella. In 20% of patients at increased kraniogramme determined
    saddle, "double" floor, the entrance expansion in the Turkish saddle, which is
    signs of the presence of prolactinoma (macroadenoma) pituitary. Where
    kraniogramme when there are no changes, we recommend holding
    X-ray CT or MRI imaging to detect
    mikroprolaktinom pituitary size less than 10 mm.

    If confirmed by the presence of macroadenoma, held
    examination of the fundus and visual fields to determine the spread of
    tumor outside the Turkish saddle - on the optic chiasm.



    How is the treatment of hyperprolactinemia

    Methods of treatment of hyperprolactinemia include medications, radiation therapy and surgery.

    When hyperprolactinemia caused microadenomas
    functional pituitary or increased levels of prolactin, the main
    is the use of dopamine agonists, reduces
    prolactin level in the blood is often reduced to normal
    a few weeks after starting treatment.

    These drugs are prescribed in cycles of 6-24 months. At the time of their admission control prolactin levels and measure the basal temperature.
    menstrual cycle is restored As the normalization of prolactin and
    ovulation (in 80% of cases), 70% of pregnancy occurs.

    While taking drugs almost all prolactinomas
    decrease in size. When macroadenomas pituitary question of method
    the treatment is decided jointly by a gynecologist and a neurosurgeon. In connection with
    effectiveness of drug treatment with prolactinomas are rarely
    resorting to surgery and radiation therapy. Only a small proportion of patients with
    macroprolactinoma whose tumor size is reduced by the background
    medical treatment, surgery may be necessary. This operation
    currently underway through a small incision near the sinuses.
    Sometimes the experts recommend to carry out radiation therapy, which allows
    stop taking the medication. However, it is possible to develop
    pituitary insufficiency.

    As treatment may also be administered
    Some hormones: glucocorticoids if
    adrenal insufficiency, L-thyroxine in the presence of failure
    thyroid (hypothyroidism), and sex hormones (estrogens) in
    as replacement therapy.

    Patients with hyperprolactinemia should be constantly observed by specialists.

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