Prolactin: Functions, Levels and Health Risks

What Is Prolactin?

Prolactin is a hormone produced by the pituitary gland, a small but important gland located at the base of the brain. This hormone plays a vital role in various functions, especially related to reproduction and lactation.

For women, prolactin is essential for breast development during pregnancy and for the production of breast milk after childbirth. Although it is commonly associated with women, prolactin is also present in men and plays a role in regulating reproductive health.

In addition to its role in breastfeeding, prolactin levels can affect various bodily processes. Prolactin tests are often used to diagnose certain medical conditions related to the pituitary gland, thyroid disorders, or reproductive health issues.

When Is Prolactin Testing Recommended?

Prolactin testing is typically recommended when doctors suspect an issue with hormone levels that may affect reproductive or pituitary function. It can also help in diagnosing certain conditions and monitoring treatment.

Here are the common reasons why a prolactin test might be prescribed:

• Infertility in both men and women
• Lack of breast milk production in women after childbirth
• Unexpected breast milk production (also known as galactorrhea), including in men
• Breast tenderness or discomfort
• Abnormal menstruation
• Breast enlargement in men
• Early menopause symptoms
• Monitoring of pituitary tumors or related disorders
• General check-up for hormonal health

How Is Prolactin Testing Conducted?

Prolactin testing is most commonly done through a blood test. A sample of venous blood is drawn from a vein in your arm and analyzed for hormone levels. Prolactin may also be measured using urine test in certain cases, although this is less common.

Prolactin tests are often part of broader panels of tests when a doctor is looking for hormonal imbalances. For example, a hormonal panel may include prolactin alongside other hormones such as thyroid hormones or sex hormones.

Preparations

• It is best to do the test in the morning, as prolactin levels naturally fluctuate throughout the day, being highest after waking up.
• Avoid stress, as stress can temporarily increase prolactin levels.
• Refrain from eating or drinking anything other than water for at least 6-8 hours before the test.
• Breast stimulation (like breastfeeding or physical contact) before the test should be avoided, as this can also affect prolactin levels.

What Are the Normal Prolactin Levels?

Prolactin levels can vary depending on gender, age, and pregnancy status. Here are the typical ranges:

• Males: 2.0-18.0 ng/mL
• Non-pregnant females: 3.0-30.0 ng/mL
• Pregnant women: 10.0-209.0 ng/mL
• Postmenopausal women: 2.0-20.0 ng/mL

Note: The units of measurement and the normal ranges can differ depending on the laboratory and the specific methods used

What Do Abnormal Levels Mean?

When prolactin levels are outside the normal range, it could indicate underlying health issues. High or low levels can signal hormonal imbalances or problems with organs like the pituitary gland.

High Levels

High prolactin levels, also known as hyperprolactinemia, can result from several causes. It is important to consult with a healthcare professional to determine the exact cause. Some common causes include:

• Stress: Physical or emotional stress can elevate prolactin temporarily.
• Pregnancy and breastfeeding: Naturally, prolactin levels rise during pregnancy and while nursing to help with milk production.
• Pituitary tumors: Known as prolactinomas, these benign tumors can cause high prolactin.
• Thyroid disorders: Conditions like hypothyroidism can lead to increased prolactin levels.
• Obesity: Higher body weight can affect hormone production.
• Kidney or liver disease: Both can impact the body's ability to clear hormones from the blood.
• Polycystic ovary syndrome (PCOS): A hormonal disorder affecting women, sometimes linked to elevated prolactin.

To manage high prolactin levels, here are a few practical steps:

• Work with your doctor: Investigate the underlying cause, whether it's related to stress, medications, or another condition.
• Monitor thyroid function: Ensure your thyroid hormone levels are checked, as thyroid issues can contribute to high prolactin.
• Manage stress: Engage in stress-reducing activities like meditation or light exercise.
• Maintain a healthy weight: If obesity is a contributing factor, work on a balanced diet and regular physical activity.
• Follow treatment for underlying conditions: Address any medical issues like PCOS, liver disease, or a pituitary tumor as guided by your healthcare provider.

Prolactin Low Levels

Low prolactin levels, though less common than high levels, can indicate other health problems. Low levels are usually linked to issues with the pituitary gland or other hormonal imbalances. Some common causes include:

• Pituitary disorders: Hypopituitarism, a condition where the pituitary gland doesn’t produce enough hormones, can result in low prolactin.
• Menopause: Hormonal changes during menopause can naturally lower prolactin levels.
• Liver failure: The liver plays a key role in hormone processing, and its failure can lower hormone levels, including prolactin.
• Hypoglycemia: Insulin-induced low blood sugar levels can sometimes cause a drop in prolactin.

If your prolactin levels are low, here are some steps to take:

• Consult with your doctor: Get a thorough evaluation to understand the cause of the low prolactin.
• Test for pituitary function: Your doctor may run tests to check for hypopituitarism or other related conditions.
• Address liver health: If liver problems are involved, consider lifestyle changes or treatments that support liver function.
• Monitor blood sugar levels: If hypoglycemia is a factor, work on managing blood sugar through diet and medical guidance.

Which Specialist Should You Consult?

When dealing with abnormal prolactin levels, it's important to consult the right specialist to ensure proper diagnosis and treatment. Here are the specialists commonly involved:

• Endocrinologist: A hormone specialist who can help diagnose and treat prolactin-related issues, including pituitary gland disorders.
• Gynecologist: Particularly important for women, as prolactin often affects reproductive health and pregnancy.
• Reproductologist: If infertility is a concern, a reproductologist can assist in managing hormone-related fertility issues.
• General practitioner: For initial diagnosis and referrals to specialists, your regular doctor can be a good starting point.

By working with the appropriate specialists, you can get personalized treatment and advice to manage your prolactin levels effectively.