Exploring the Link Between High Prolactin Levels and Unmarried Women: Causes, Symptoms, and Treatment Options
How many of you know about female hormones, particularly the prolactin hormone secretion and function? Prolactin hormone releases from pituitary glands present at the brain’s base and maintains menstrual cycles in unmarried females. The production of prolactin hormone becomes high in pregnant women as it triggers the development of mammary glands and milk production in the female breast. Sometimes, for specific reasons, if prolactin production increases in unmarried women, it disturbs menstrual cycles and causes milky discharge from nipples. Treatment involves medicines to stop or reduce prolactin production and radiation therapy or surgery in some patients.
Highlights
- Prolactin hormone releases from pituitary glands present at the brain’s base and maintains menstrual cycles in unmarried females.
- The production of prolactin hormone becomes high in pregnant women as it triggers the development of mammary glands and milk production in the female breast.
- Sometimes, if prolactin production is high due to certain reasons, it disturbs menstrual cycles and causes vaginal dryness in unmarried females. While low sex drive, erectile dysfunction and milky discharge from nipples are common causes of high prolactin in males.
- Treatment of high prolactin includes medicines to regress the activity of prolactin-producing cells and prolactin production, while doctors recommend radiation therapy and surgery to patients if medication is not working.
What is the prolactin hormone?
Prolactin also called luteotropic, or luteotropin hormone, is a hormonal secretion from pituitary glands residing at the base of the brain. Vital functions of the prolactin hormone include lactation and the development of mammary glands in female breasts during pregnancy. Prolactin hormone naturally produces low levels in males and unmarried females. It is responsible for maintaining menstrual cycles in unmarried females, while no proper function of prolactin is known yet in males. In pregnant females, prolactin produces at higher levels to cause the development of milk-producing mammary glands essential for milk production to breastfeed newborn babies. Although ovaries, the immune system and the uterus produce prolactin in low quantities, the primary source of prolactin is pituitary glands which are pea-sized glands residing at the base of the brain below the hypothalamus. Prolactin production from pituitary glands largely depends on the brain chemical “dopamine” and estrogen hormone in females.
Besides, nipple stimulation, stress and exercise may also contribute to the production of prolactin hormone.
Causes of high prolactin
Prolactinomas, certain medications, and health conditions are common causes of high prolactin in unmarried females and males (Figure 1).
Prolactinomas
Prolactinoma is a type of pituitary adenoma that occurs due to benign tumor formation in prolactin-producing cells, called lactotrophs of the pituitary gland. They are the most common cause of high blood prolactin. Most cases of prolactinomas are found in females than males and patients younger than 40 years old. Doctors usually recommend chemotherapy against prolactinomas; however, radiation therapy and surgical removal of prolactinomas is also a viable option for treating high prolactin.
Medications
Dopamine and estrogen hormone are naturally occurring prolactin-inhibiting factors (PIFs) in humans. Studies have found that high dopamine secretion has an inverse effect on prolactin, meaning that high dopamine secretion decreases prolactin secretion from pituitary glands. Still, certain medications that may affect dopamine secretion negatively influence prolactin secretion. Other drugs that may increase prolactin levels in the blood include:
- Antipsychotic medicines such as risperidone
- High blood pressure medicines
- Medicines used for nausea and vomiting, and
- Opioids containing pain-killing medicines
Although medications can increase prolactin levels in the blood, this increase in prolactin is temporary that lasts no more than 3-4 days of stop taking the medicines.
Health conditions
Besides tumor formation in the pituitary glands and medications, various health conditions may also cause high prolactin production and high blood prolactin in unmarried females or males. These health conditions include kidney diseases, underactive thyroid or hypothyroidism (low thyroid hormone secretion), and shingles (small blisters or rashes) on the chest.
Symptoms
Symptoms of high prolactin vary in females and males. Irregular menstrual cycles and vaginal dryness, pain and discomfort are common symptoms of high blood prolactin in females. On the contrary, erectile dysfunction, breast enlargement, milky discharge from nipples, and low testosterone levels are common symptoms of high blood prolactin in males.
Diagnosis
Diagnosis of prolactin levels in the blood is the easiest way to determine high prolactin in both males and females. Breast enlargement, milky discharge from nipples, low sex drive, low testosterone, and erectile dysfunction are various ways to diagnose high prolactin in males.
Treatment
Treatment of high prolactin production includes medicines that regress prolactin-producing cells and increase dopamine secretion to reduce prolactin production. Cabergoline and Bromocriptine under brand names “Dostinex®” and “Parlodel®” effectively regress the activity of prolactin-producing cells, so lower prolactin production and blood prolactin level within 2-3 weeks of prescription. These drugs have side effects such as changing blood pressure and mental fogginess, but these side effects go away with time in most patients. After a few years of medications, spontaneous regression of prolactinomas has been seen in patients. Few patients do not respond to chemotherapy, so doctors recommend radiation therapy or transsphenoidal adenoma resection surgery.
