Hyperprolactinemia: Symptoms, Causes and Effect on Fertility

How does hyperprolactinemia affect fertility and getting pregnant?

The right ratio of reproductive hormones must be present at the proper time, working in harmony with one another to promote fertility and pregnancy. Fertility can be affected whenever one of those hormones is out of balance.

Inadequate levels of prolactin can cause irregular ovulation and have a negative effect on the luteal phase, or second half of the menstrual cycle, which can have an adverse effect on fertility. The hormone that encourages the maturation of ovarian follicles, follicle-stimulating hormone (FSH), can also be inhibited by excess prolactin. Ovulation cannot occur without FSH because it is necessary for conception.

Though the connection between elevated prolactin levels during pregnancy and an increased risk of miscarriage is not well established, some experts have this theory

Symptoms of hyperprolactinemia may include:

  • Irregular periods
  • Lack of periods
  • Irregular ovulation
  • Anovulation (no ovulation)
  • A milky discharge from the nipples not related to breastfeeding
  • Hyperprolactinemia can occasionally have unknown causes, but in the majority of women, one (or more) of the following factors is to blame:

  • Hypothyroidism (about half of all women with hyperprolactinemia have thyroid dysfunction)
  • Polycystic ovary syndrome or PCOS
  • Benign tumors in the pituitary
  • A kidney condition
  • Excessive stress
  • Excessive exercise
  • Lack of sleep
  • Certain foods
  • Certain medications (such as some antipsychotics, antidepressants and blood pressure medicines)
  • The method of treatment will depend on what caused your hyperprolactinemia. To rule out the possibility of a small benign growth, your doctor may order additional blood tests and possibly an MRI of the pituitary gland.

    Depending on the cause, treatment may include:

  • Taking medication to lower prolactin levels. Youll usually stop taking these medications aonce you become pregnant.
  • Stopping any medication that may cause high prolactin levels. Your doctor might recommend an alternative instead.
  • Medication or surgery to remove benign tumors in the pituitary. Medications these days effectively treat the vast majority of tumors without surgery. But if the tumors are larger, at risk of damaging other structures in the brain or causing signficant symptoms, surgery might be the best choice.
  • Treating hypothyroidism. Such treatment will usually make hyperprolactinemia go away if it was due to hypothyroidism.
  • If you’re having trouble conceiving, your doctor may order some tests to determine whether hyperprolactinemia is a factor in your fertility issues. Excess prolactin can be detected by blood tests, and the cause of the condition will determine how to treat it. Your doctor might advise getting a CT or MRI scan, or they might refer you to an endocrinologist. Hyperprolactinemia can make getting pregnant more difficult. But the good news is that with the right care, prolactin levels can be brought back to normal, increasing your chance of getting pregnant.

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    Having trouble getting pregnant if your hormones are out of balance What you should know about excessive prolactin levels is provided below.

    Prolactin levels that are too high can cause problems with conception. Fortunately, treatment can restore your prolactin levels to normal, putting you back on the path to productive conception.

    Hyperprolactinemia is, simply, high levels of the hormone prolactin. Prolactin is a hormone released by the pituitary gland that, among other things, causes a woman to produce breast milk after giving birth to a child.

    It’s expected that new moms have high levels of prolactin. But when they are not breastfeeding, some women have abnormally high levels of prolactin, which could cause some issues.

    A quick blood test performed at the fertility doctor’s office can measure prolactin. Prolactin should be drawn first thing in the morning for accurate results. The woman was supposed to have fasted the previous evening and refrain from any breast or nipple stimulation the day before.

    Prolactin may cause infertility in several different ways. First, prolactin may stop a woman from ovulating. If this occurs, a woman’s menstrual cycles will stop. Ovulation may occasionally be disrupted by high prolactin levels in less severe situations. Ovulation would then be irregular or take a very long time to happen as a result of this. Women in this category may experience infrequent or irregular periods. The mildest forms of high prolactin levels can cause women to ovulate regularly but not produce enough progesterone after ovulation. This is known as a luteal phase defect. A uterine lining that produces insufficient amounts of progesterone may make it more difficult for an embryo to implant. Some affected women may experience their period beginning soon after ovulation.

    Cabergoline is typically not the first option for treating high prolactin levels because it is more expensive. When Parlodel is ineffective or a woman cannot tolerate the side effects, it is typically used. Cabergoline is a longer acting medication. Instead of every day, it is typically administered twice a week.

    The hypothalamus, a part of the brain, releases hormones when a woman has an underactive thyroid gland in an effort to stimulate the thyroid gland. The pituitary may produce too much prolactin as a result of this hormone. Thyroid and high prolactin levels will be corrected as a result of treatment with thyroid hormone supplements.

    Prolactin comes in a variety of shapes known as isoforms or isotypes. Even though all of the forms are measured together on a standard prolactin blood test, not all of them affect reproduction. Because of this, if a prolactin level is elevated, it should be checked again with a more thorough test that examines each isoform separately.

    Pregnancy: How to conceive when prolactin levels are high? – Dr. Nupur Sood

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