Prolactin is defined as a type of hormone secreted by the pituitary gland in the human brain. It is the hormone that facilitates the development of the mammary glands in women during pregnancy and the production of milk after childbirth. For this reason, prolactin is also commonly referred to as the “milk hormone.” In men, however, elevated prolactin levels can lead to problems such as decreased testosterone levels, loss of sexual desire, reduced sperm quality, and infertility.
A prolactin test is used to check for high or low levels of the prolactin hormone. It is recommended that the prolactin test be performed in the morning, as the hormone is most active at this time and can provide the most accurate results. He should not have sexual intercourse with his partner before the test, as the hormone does not reflect its true value during sexual activity. The test is performed via a blood draw; therefore, he must not eat anything before the test.
Why Does Prolactin Level Rise?
The prolactin hormone, which is secreted during pregnancy, facilitates the development of the mammary glands and the production of breast milk. However, if a man is not pregnant, elevated prolactin levels indicate the presence of certain health issues. Causes of elevated prolactin levels—also known as hyperprolactinemia—include benign tumors in the pituitary gland (known as prolactinomas), polycystic ovary syndrome, and kidney and liver disorders. Benign tumors in the pituitary gland, as well as tumors larger than 1 cm in size—known as macroadenomas—can cause hyperprolactinemia. To detect these tumors, a radiologist must be consulted. The radiologist performs an MRI to make the diagnosis. For the treatment of micro- and macroadenomas, medication is used instead of surgical procedures. However, pituitary tumors that cannot be treated with medication or that pose a risk are removed through surgery. Additionally, hyperprolactinemia can occur due to the effect of the TRH hormone—which stimulates the secretion of thyrotropin—as a result of hypothyroidism, a condition in which the thyroid gland is underactive. Some diseases that cause elevated prolactin levels include the following:
- Tight underwear
- Anxiety
- Sleep disorders
- Psychiatric medications
- Pituitary gland tumors
- Lung cancer
- Unbalanced diet
- Breast conditions
- Endocrine disorders
In addition, continuous stimulation of the breast to determine whether milk is present in the nipple also causes an increase in prolactin levels.
What Does High Prolactin Cause?
The hormone prolactin, which helps breast tissue develop and prepares the body for milk production during pregnancy, contributes to milk production following childbirth through breast stimulation. However, elevated prolactin levels in women outside of pregnancy and the postpartum period can lead to problems such as irregular periods, amenorrhea, infertility, and loss of sexual desire. In men, hyperprolactinemia can lead to a lack of sexual desire, erectile dysfunction, infertility, reduced body hair, and, in rare cases, nipple discharge. Additionally, it can cause headaches and vision problems severe enough to interfere with daily life.
How Is Prolactin Reduced?
The treatment process begins with identifying the underlying condition causing elevated prolactin levels. For some affected individuals, avoiding stress, eating a healthy diet, maintaining a regular sleep schedule, and wearing loose-fitting underwear can help lower prolactin levels. Generally, once the condition causing hyperprolactinemia is treated, hormone levels return to normal. If there is a tumor in the pituitary gland, it is shrunk with medication. However, if the tumor is large, it is removed surgically.
For Which Conditions Is a Prolactin Test Performed?
The prolactin test is performed by drawing a blood sample from the patient’s arm. Elevated prolactin levels can interfere with ovulation. As a result, becoming pregnant may be more difficult than usual. However, it does not prevent pregnancy. Appropriate measures and treatments must be administered by specialists. Some conditions for which the prolactin test is performed include:
- Thyroid problems
- Mental health issues
- Ovulation problems
- Pregnancy
- Breastfeeding
- Avoiding sexual activity
- Irregular periods
