Causes and treatments of high prolactin levels

Women in modern life must pay more attention to various changes in their bodies in normal times, because this is very important for their physical health. Prolactin is a hormone secreted by the female body. Prolactin has a great impact on women's physical health. If prolactin secretion is too high, it will cause some physical changes in women such as irregular menstruation, milk overflow, no ovulation during menstruation and infertility.

Causes of high prolactin

1. Hypothalamic disorders :

If craniopharyngeal tumors, encephalitis, pineal tumors, pseudotumor cerebri, pituitary stalk transection, and partial hypothalamic infarction occur in the hypothalamus and its adjacent areas, the normal function of the hypothalamus will be destroyed, causing the prolactin inhibitory factor produced by the hypothalamus to gradually decrease, leading to excessive secretion of prolactin.

2. Primary hypothyroidism :

If a woman has primary hypothyroidism, it will cause the hypothalamus to produce more thyrotropin-releasing hormone, which, when stimulating the pituitary gland to secrete thyroid-stimulating hormone, will also cause excessive secretion of pituitary prolactin.

3. Pituitary disorders :

This is mainly because various tumors in the pituitary gland, or some vacuolar sella syndrome and hyperpituitarism can cause excessive prolactin in women, leading to galactorrhea and amenorrhea.

4. Nerve stimulation :

If some parts of a woman's body, especially the skin on her chest, are stimulated by other factors, or if there is severe pain caused by nearby nerve damage, the pain will first be transmitted through the nerves to the hypothalamus, thereby increasing the secretion of prolactin and causing excessive prolactin in women.

Treatment of high prolactin

1. Drug treatment

Bromocriptine is a semi-synthetic ergoline derivative and a dopamine receptor agonist. It can promote the synthesis and secretion of PRL-IH and inhibit the synthesis and release of PRL through the receptor mechanism. It also directly acts on pituitary tumors and PRL cells to curb tumor growth and inhibit the secretion of PRL, GH, TSH and ACTH. Bromocriptine therapy is suitable for all types of HPRL and is also the first choice for pituitary adenomas (micro/macroadenomas), especially for young infertile women who hope to have children. oral. Other anti-prolactin drugs include: Levodopa, octahydrobenzoquinoline (CV205-502), vitamin B6, etc.

2. Ovulation induction therapy

It is suitable for patients with HPRL, anovulatory infertility, and those who cannot successfully ovulate and become pregnant after simple bromocriptine treatment. That is, a comprehensive therapy with bromocriptine as the main drug and other ovulation-inducing drugs in combination: bromocriptine-CC-hCG, bromocriptine-hMG-hCG; GnRH, pulse therapy-bromocriptine, etc. Combined therapy can save antiprolactin, shorten the treatment cycle and improve the ovulation rate and pregnancy rate.

3. Surgical treatment

It is suitable for patients with giant adenoma who have compression symptoms, as well as those whose tumors are resistant to drugs and who are not responsive to bromocriptine treatment.

The current transsphenoidal microsurgery is safe, convenient, and easy to perform, and its efficacy is similar to that of bromocriptine therapy. Using bromocriptine before and after surgery can improve the efficacy. The disadvantages of surgery are: if the pituitary tumor has no obvious capsule and unclear boundaries, the surgery is difficult to be thorough or may cause damage, resulting in cerebrospinal fluid nasal fistula and secondary pituitary dysfunction.

4. Radiation therapy

It is suitable for non-functional tumors of the HP system and those who are not responsive to drug and surgical treatments. Irradiation methods include: deep X-rays, 60Co, alpha particles and proton rays. Isotope 90 yttrium, etc.