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The influence of hormones in the body is simply colossal, because they regulate all life processes. Psychological health, reproductive functions, emotional condition person. The main female hormone that affects the possibility of conception, gestation and breastfeeding is prolactin.

Prolactin is a hormone synthesized by the cells of the anterior pituitary gland. The degree of influence of the hormone on a woman’s body is extremely high. If the level of prolactin exceeds the permissible norms, failures occur menstrual cycle, hormonal infertility develops.

Prolactin production occurs in the pituitary gland, one of the parts of the brain, but in small quantities it is also synthesized in the ovaries, and during pregnancy, also in the placenta and in the endometrium of the uterus. The level of the hormone in the blood also depends on another female hormone - estrogen. When estrogen in the blood increases (during pregnancy), the brain receives a command to increase prolactin levels for conception.

Prolactin significantly affects the mammary glands. It changes the structure of the mammary gland, preparing it for lactation and feeding a newborn. This explains why when a woman breastfeeds, she does not menstruate and her chances of conceiving are greatly reduced.

Important! If breastfeeding increases the level of prolactin, which is absolutely normal, then an increase in the amount of this hormone in another period is very unfavorable for conception and indicates a threat of infertility.

The normal level of prolactin in the blood of women

In women, the level of prolactin in the blood is established with the arrival of the first menstruation and remains at a level of 4-36 ng/ml until menopause. During pregnancy, prolactin increases significantly 34-386 ng/ml. For pregnancy to occur, prolactin must be within normal limits at conception.

Important! The effect of prolactin on the possibility of conception should not be underestimated. Therefore, before planning a pregnancy, a woman needs to check her hormonal balance and, if there is the slightest deviation in indicators, contact a gynecologist.

Symptoms of elevated prolactin levels

The main symptoms of increased prolactin in the blood include:

• disorders and disruptions of the menstrual cycle (spotting, cycle failure, lack of ovulation);
• discharge from the breast (galactorrhea);
• frigidity or decreased libido;
• excess hair growth;
• acne pimples;
• infertility.

Causes of elevated prolactin levels in the blood

An increase in hormone levels and problems with pregnancy can be closely related to diseases and a woman’s lifestyle. Prolactin increases rapidly during emotional overload, and stress and an active sex life especially affect its level.

Important! High level Prolactin will not make it possible to conceive a child.

The main reasons for the increase in hormones:

• intense physical activity;
• taking antiemetics, psychotropics, contraceptive drugs, tranquilizers;
• operations, breast injuries, uterine curettage;
• the presence of an intrauterine device.

Some diseases can also affect prolactin levels:

• hypothyroidism;
• anorexia;
• prolactinoma (one of the types of pituitary tumor);
• liver and kidney diseases;
• neoplasms.

How to determine prolactin levels

To determine the level of prolactin in the blood, it will be enough to take a blood test.

Important! Before taking blood, you must minimize stress, do not take a hot shower or bath, do not visit the bathhouse or sauna, and abstain from sexual intercourse and alcohol consumption.

Blood sampling is carried out in the morning, 2-3 hours after waking up, on an empty stomach. If, after receiving the results, abnormalities are identified, you will need to consult an endocrinologist and gynecologist.

Prolactin during pregnancy

Cases where pregnancy occurs with elevated prolactin levels at conception are not uncommon. But in such a situation there is a threat of spontaneous abortion. Therefore, it is necessary to normalize the level of the hormone in the blood as soon as possible so as not to provoke a miscarriage.

Treatment

Treatment to normalize prolactin levels is carried out after medical examination. This is mainly drug therapy. They take the following drugs: Cyclodinone, Mastodinone, Bromocriptine, Dostinex, Parlodel, etc. The course of medication is long: from six months to a year. Periodically you need to take control tests and measure your basal temperature.

If a neoplasm is detected in the pituitary gland, it is first prescribed drug treatment, and if it does not bring the desired result, surgical intervention is performed.

Prolactin and IVF

Before carrying out the IVF (in vitro fertilization) procedure, it is necessary to determine the level of prolactin.

Important! Elevated prolactin and IVF are incompatible, and the operation will be unsuccessful. The entire procedure will end in embryo rejection.

In order for a long-awaited pregnancy to occur as a result of IVF, prolactin must be reduced. An increase in prolactin after embryo transfer indicates that the pregnancy is going well and the embryo has taken root in the body of the uterus. After embryo transfer, the woman is prescribed drugs that maintain progesterone levels, these include Duphaston or Utrozhestan. They should be taken until 14 weeks of pregnancy, while the baby's place is being formed.

Take care of your health, spend less time under the scorching rays of the sun, which stimulate the hypothalamus and, accordingly, the pituitary gland. You should not get carried away with sleeping pills. Having noticed discharge from the mammary glands, there is no need to squeeze it out, thereby stimulating the production of prolactin. It is better to seek help from a gynecologist in order to begin correcting the hormonal levels in the blood in time.

All systems of the female human body are dependent on each other, and hormones control the processes. Today we'll talk about prolactin - female hormone, the excess of which causes infertility. It has been proven that prolactin and ovulation are closely related.

What is prolactin

Prolactin is a hormone synthesized by cells of the pituitary gland, the endometrium (the lining of the uterus), the ovaries and, if a woman is pregnant, the placenta. Exceeding the norm of prolactin is called .

This condition is dangerous not only due to infertility. Complications of hyperprolactinemia:

• disruption of the functioning of all human endocrine glands - ovaries, adrenal glands, pituitary gland and thyroid gland;
• loss of vision;
• malignancy of benign pituitary tumors.

A significant excess of the hormone level ends with the cessation of menstruation - amenorrhea. And this is not only infertility, but also .

Also elevated, For example, . The hormone causes the formation of ducts in the mammary glands and their clogging (if there is no pregnancy). A week with mastopathy will end with surgery.

How is elevated prolactin related to ovulation?

This hormone is responsible for lactation and suppresses the hormone that stimulates the maturation of follicles in the ovaries, in which the egg matures. If the follicle does not mature, there is no mature egg, which means that conception is not possible. It is for this reason that many women do not become pregnant during lactation - when breastfeeding. Excess prolactin required to form sufficient amounts breast milk, blocks ovulation.

If female infertility is suspected, the gynecologist first prescribes tests for prolactin and to check the quality of follicle maturation. And since increased prolactin and ovulation are closely related, already based on the results of the first analysis, treatment can be prescribed, after which pregnancy will occur.

Having passed and discovering increased level prolactin, you can’t take hormones thoughtlessly. First you need to find the reason whyelevated prolactin and no ovulation. Eliminating the cause will restore the hormone level and affect all body activities.

Why does prolactin increase?

Normally, the reasons for an increase in this hormone are only 2 conditions: pregnancy and lactation. Those. Only during these periods are prolactin levels naturally higher than usual. Nature provides this so that the woman can calmly endure pregnancy - during this period she does not need ovulation, and then can feed the newborn.

If ovulation is absent in any other period (except menopause and before puberty), this means that physiological and pathological factors are preventing the maturation of follicles in the body.

Physiological factors that increase prolactin:

• stress, increased emotionality;
• active training and physical activity;
• breast stimulation with caresses;
• incorrectly selected hormone-containing(Navy);
• hormonal drugs that affect the activity of the pituitary gland and ovaries;
• recovery period after , , operations on the mammary glands, etc.

Pathological factors causing hyperprolactinemia:

• tumors of the pituitary gland (prolactinoma) and hypothalamus, which interfere with the activity of these parts of the brain;
• - PCOS
• tumors in the mammary glands and organs of the reproductive system;
• problems with the kidneys, adrenal glands, severe liver damage(cirrhosis);
• anorexia, causing weight loss and inhibition of the functions of the reproductive system.

From the above we can conclude that the absence of ovulation, even if there are children, requires mandatory examination and or . An increase in prolactin levels does not occur without a serious reason that destroys the body.

Signs to check your prolactin levels

The main symptom of hyperprolactinemia is the absence of ovulation; in addition, it is important to pay attention to the following symptoms:

• decreased libido;
• increased hair growth on the body - arms, legs, face;
• the appearance of acne;
• bad mood, increased irritability, moodiness;
• change in taste preferences;
• discharge from the nipples, breast swelling outside the period before menstruation.

If these symptoms occur, you should immediately consult a doctor. and get tested for hormones.

How to prepare for prolactin tests

The hormonal system works according to special rules. The production of hormones is affected by the time of day, moral state, sexual activity, etc. This means that in order to obtain accurate results of a prolactin test, it is necessary to exclude any influence of factors unusual for the usual lifestyle.

Before donating blood you need:

• Avoid stress, taking antidepressants and alcohol, thermal procedures, incl. hot bath, smoking;
• Postpone sexual intercourse and taking hormonal medications;

These recommendations do not mean that blood for prolactin cannot be tested in the evening or in another phase of the cycle. If the condition requires urgent examination, you can take an analysis urgently and, if there are real deviations, then clarify it. This will enable the gynecologist to confirm the preliminary diagnosis or refute the presence of hyperprolactinemia.

Prolactin and ovulation: deciphering prolactin tests

The test results are compared with a table of norms, which depends on the phase of the cycle. Further actions depend on the conclusions.

• If there is a slight excess of the hormone, it is necessary to take an additional test for macroprolactin.
• If the standards are high, the doctor will refer you to , , and other examinations.

Treatment of infertility associated with lack of ovulation with elevated prolactin

When the norms and reasons for changes in prolactin concentration are established, the doctor will prescribe treatment.

• Ovulation is restored by hormones that reduce prolactin levels in the blood. The dose of such medications is carefully calculated, because low prolactin is no less dangerous than high prolactin. The course lasts at least several months, and sometimes treatment lasts for years.
• Tumors of the pituitary gland, adrenal glands, etc. confirmed by MRI, they are treated . This is a complex process that we will not describe in this article - this is a topic for a separate discussion.
• The ovulation process is monitored by ultrasound - folliculometry.

It happens that the hormone is elevated for reasons that are easy to eliminate, for example, enough or . In this case, no treatment will be required.

Where to get tested for prolactin and treat infertility in St. Petersburg, prices

Timely tests and adequate measures are a guarantee that a woman facing the problem of increased prolactin will restore ovulation and infertility will be a thing of the past. You can take hormone tests and get a consultation with an experienced gynecologist-endocrinologist in St. Petersburg without a queue and inexpensively at the specialized gynecological clinic Diana.

The price of an appointment with a gynecologist is affordable for every patient - the initial appointment costs 1000 rubles, and the appointment based on the results of the examination is only 500 rubles. Taking blood for analysis will cost 170 rubles.

Hormones are invisible and cannot be touched, but these little workers control our body.

More than 100 types of these biologically active organic substances are known, but who knows how many of them have not yet been discovered?

IN female body special hormones are produced that allow you to realize yourself in the role of a mother - to conceive and bear a baby, to feed him. Prolactin belongs to this group.

Although the main function of the hormone is to support lactation, it can also be called a regulator of conception. And women planning a pregnancy need to know about this. How does prolactin affect conception?

How is the hormone prolactin related to conception?

Everyone has prolactin - both women and men. True, the latter have a minimal concentration.

In women, in addition to regulating the production of breast milk, the hormone also performs other functions:

1. is a natural analgesic (reduces pain);
2. takes part in the mechanism of orgasm formation;
3. responsible for sexual desire;
4. controls the menstrual cycle.

This lactotropic hormone inhibits the ovulation cycle, prolongs the existence of the corpus luteum in the ovary, lengthening the luteal phase of the cycle. If ovulation is inhibited, pregnancy does not occur.

This is a natural mechanism that prevents the next baby from becoming pregnant while the previous one is still a baby. That is why during the lactation period there are no periods for a long time.

Prolactin levels for successful conception

Hormone balance is an important condition for conception. But if this balance is upset, reproductive function is disrupted.

According to statistics, up to a quarter of women undergoing infertility treatment suffer from an imbalance of lactotropic hormone. How does prolactin affect conception?

Elevated prolactin

Elevated prolactin and conception are often incompatible. If the concentration of lactotrope is more than normal, this condition is called hyperprolactinemia.

It is caused by several factors:

• Physiological, while being a variant of the norm: during pregnancy and breastfeeding a child, as well as during physical fatigue, stress, and even during sleep or sex.
• Pathological, that is, caused by certain diseases (liver cirrhosis, kidney failure, polycystic ovary syndrome, brain tumor, etc.).
• After therapy with certain drugs: antihistamines, contraceptives, hormonal drugs.

What is dangerous about elevated prolactin and how does it affect conception?

With hyperprolactinemia, menstruation is interrupted or absent, and therefore ovulation, without which fertilization is impossible.

Important! When the hormone is high, the body is “misled” into believing that there is already a pregnancy, and does not allow a new one!

High prolactin is also dangerous for the planned breastfeeding: the mammary glands change their structure, breast cancer may develop.

Reduced prolactin

If the hormone level is low, pregnancy is quite likely; a decrease is not as dangerous as an increase. It is more important that he “grows up” when conception occurs.

The norm for prolactin for conception is 4-36 ng/ml. A blood test can accurately determine hormone levels.

It is taken with absolute calm; a couple of days before the test, physical overload, stressful situations, coffee and alcohol, and sex are excluded.

Important! The hormone is sensitive to emotions and noticeably “grows” with the production of seratonin and adrenaline!

Conclusion

Balan is important in everything, and first of all, in hormones. After all, it is thanks to them that our life not only goes on, but also continues.

That is why normalization of hormonal levels is an important condition for planning pregnancy.

Video: Prolactin is increased

05.04.2006, 15:49

Good afternoon
I haven’t been able to get pregnant for 5 months now - I understand that this, of course, is not a period, nevertheless... I have increased prolactin (700), nipple discharge (colostrum), ovulation (proven by ultrasound), normal (13 mm in in the middle of the cycle) the size of the follicles, no disturbances in the internal female organs, and a 29-day cycle like clockwork, and chronic inflammation of the appendages - I am treated periodically, usually the doctor prescribes aloe.
What is not, there is definitely no tumor in the pituitary gland, they checked it on an MRI with a contrast agent, and there are no abnormalities in other hormones either, and there is no child :(
I got pregnant, easily, a long time ago, about 10 years ago, I had a mini-abortion. Now I’m about to get pregnant and give birth, it’s too late, of course: rolleyes:
The question is why it doesn’t work out, what do you think, dear doctors?
I forgot to write that my child’s supposed father’s sperm count is fine.

05.04.2006, 16:12

Good afternoon!

First, clarification is necessary, because It’s unlikely that anyone will immediately answer such a question (and especially in absentia):

1. The normal prolactin level in the laboratory is 2-15 mcg/l (ng/ml) or something else?
2. Please indicate all the hormones that were determined for you, especially TSH.
3. Was testing done for infectious diseases?
4. How long ago did discharge from the mammary glands appear?
5. Do you smoke (etc.), what medications have you taken over the past year?

Vyacheslav Shurygin, endocrinologist.

05.04.2006, 16:25

Dear colleague!

Our patient is ovulating, sedative, prolactin cannot be indicated in ng/ml in the worst nightmare. ITS prolactin is indicated in honey/ml, but it doesn’t matter - the first thing is whether there is macroprolactinemia (big prolactinemia), see the search, because this prolactin is not a hindrance to anything. Infertility is secondary. That is, they are looking in the wrong place. where they were lost, and where it was light and ahead of time.

05.04.2006, 21:55

first, is there macroprolactinemia (big prolactinemia), see the search, because this prolactin is not a hindrance to anything. Infertility is secondary. That is, they are looking in the wrong place. where they were lost, and where it was light and ahead of time.
TSH, however, will not hurt, nor will telling you about all the medications you are taking.

Dear Galina Afanasyevna!
IN Once again thank you for the science!
If you believe in the presence of ovulation, of course, the most likely is big- or big-big-prolactinemia... Only with ultrasound, incidents still happen. Determining IGF-1 in this situation will shed light in the right place and at the right time??? :o

06.04.2006, 11:04

Good afternoon. The test results are at home, but everything is definitely normal, I’ll copy it tomorrow. B Lately I took bromocriptine (2 months), which did not help at all, as the discharge from the chest remained and did not even decrease: (For inflammation, I was prescribed aloe injections with an interferon imulsifier every 20 days, everything else was minor headaches, etc., like everyone else. Infections were clear on PCR. I had thrush, now everything was cured with pure neopentotran, the doctor looked and said everything was clear. I don’t smoke, I drink a lot of coffee - maybe it has some effect?

06.04.2006, 11:55

06.04.2006, 14:14

5 months is not a long time for such an important matter.
But seriously, you have a limit of 12 months, with normal prolactin(and even slightly elevated) bromocriptine will not help you, and coffee will not harm you. Another thing is more important - you (you and your husband) must have a certain rhythm of relationships (business trips, etc.).
Yes, the fact of the matter is that for the last three months we have been making love exactly on the day of ovulation - I go for an ultrasound, they tell me - “ovulation”, and we are ahead - a couple of days for sure :) Prolactin is not very elevated, then why is it “flowing” like that? "from the chest?

06.04.2006, 16:02

there is the concept of genetic selection, when pregnancy is terminated on its own at short notice, and menstruation occurs on time or with a slight delay (this has already been written about in other discussions). that is why the expected pregnancy period is 12 months. The discharge does not interfere with pregnancy.

19.04.2006, 11:47

Good afternoon
Sorry for the long silence - I was taking some tests
Here are the results
TGG-2.55 at a norm of 0.3-6.0 mIU/l
T3-1.79 nmol/l with a norm of 1.2-3.2 nmol/l
T4-102 nmol/l at a norm of 60-160 nmol/l
A/TPO 22.5 IU/ml norm 30 IU/ml
LH 3.8 IU/l when the norm is 1-10.5
FSH 7 IU/l, normal 3-12
Prolactin 734 at normal 250-500
Cortisol 267 nM/l when normal is 110-500
Estradiol 228.4 nM/p at a norm of 110-700
Testosterone 1.4 nM/l with a norm of 0.2-2
Progesterone 3.6 with a norm of 0.2-4
Everything seems to be normal, except for prolactin
And the ultrasound showed diffuse hyperplasia of the 2nd degree: confused:
What do you think, dear doctors, all of the above can somehow clarify why it’s still not possible to get pregnant? Thank you

21.04.2006, 19:59

Since the diagnosis of diffuse hyperplasia of the thyroid gland has not existed for about twenty years, and the unit of measurement for the volume of the gland is cm3, it is easier to indicate the number.
In the presence of ovulation, a slightly elevated prolactin level is most often due to big-prolactinemia (macroprolactinemia)

22.04.2006, 10:47

You are ovulating, the main thing for you, as I understand it, is to stop the flow of milk from your breasts. Maybe the dose of bromocriptine was insufficient? Typically, a couple is tested for pregnancy after 12 months of regular sexual activity in the absence of pregnancy.
pregnancy. To interpret sex hormones, I personally want to know the phase of the menstrual cycle. There are many reasons for prolactinemia. Thyroid hormones are normal. Therefore, the thyroid gland should not be the cause of increased prolactin. There is such a thing as idiopathic prolactinemia.
With uv. Irina.

When faced with a problem such as hyperprolactinemia in preparation for conception, a woman often wonders: is it possible to get pregnant with elevated prolactin?

An increase in the synthesis of mammotropin affects the inhibition of the ovulation process, which can cause infertility.

But even with such a disappointing test result as high prolactin, there are nuances and methods of treatment.

Participates in many processes:

1. It provides reproductive function.
2. Prolactin is involved in the work internal organs.
3. It affects the functioning of the immune system.

The main function of luteotropin is reproductive. It can be divided into three components:

1. Helps in the development of the placenta.
2. Provides lactation process.

It can be seen that the lactogenic hormone takes part in all stages of a woman’s reproductive role.

Its concentration in the blood is important both for conception and for carrying a baby and its subsequent feeding.

Why does a pregnant woman need prolactin?

During pregnancy, this is a normal physiological state of a woman.

Mammotropin during pregnancy is engaged in the following activities:

1. Forms the inner layer of the uterus.
2. Converts breast adipose tissue into glandular tissue.
3. Reduces pain.
4. Affects the development of the child's lung tissue.

But if the increase in luteotropic hormone after conception plays a positive role, then high prolactin when planning pregnancy can become an alarming signal.

Interesting!

With the assistance of prolactin, surfactant is synthesized - a special substance that helps the child’s lung tissue not to stick together. It is secreted almost before birth, and its deficiency can lead to the death of the newborn.

Reasons for increased prolactin

In addition to infertility as a consequence, such a condition will indicate such a troublesome disease as prolactinoma. Hyperprolactinemia also occurs for the following reasons:

1. Adrenal insufficiency.
2. The use of potent drugs to treat infections, nervous system.
3. Long-term use of COCs.
4. Venereal diseases.
5. Head injuries or chest.
6. Starvation.

Some causes are temporary and prolactin returns to normal indicators after lifestyle changes.

Minor deviations from the norm can be stopped with the help of medications, and after pregnancy you can begin surgical treatment adenomas.

Preventive measures

During the period of preparation for conception, you should pay attention to your lifestyle. Requires attention the following areas woman's life:

1. Maintaining emotional balance.
2. Regulation of work and rest schedules.
3. Daily gymnastics.
4. Proper nutrition.
5. Use of vitamin and mineral dietary supplements

Such measures will have a beneficial effect on stabilizing work endocrine system in general, as well as the normalization of hormones, including prolactin. In this case, medical intervention may not be necessary.

Diagnosis is made primarily by. It is taken subject to the following rules:

1. Strictly in the morning hours.
2. Should go away after sleep no less two hours.
3. Do not eat minimum 10 hours before analysis.
4. Avoid stress and excess physical activity 2 days before screening.
5. Do not produce manipulations with the mammary glands.
6. Can't convey protein food.

Should be 4.5–49 ng/ml, or 136–1483 µIU/ml.

But during ovulation and before menstruation, its value may increase slightly.

To confirm hyperprolactinemia, the test must be done at least 2 times. One analysis may not be informative.

Macroprolactinemia

If prolactin is found to be elevated, laboratory technicians will test for macroprolactin, which may affect total luteotropin.

Even if the percentage of macrotropin is high, this condition will not affect the possibility of conception in any way. Macroprolactin is an inactive form of prolactin that does not affect reproductive function.

Diagnosis of pituitary adenoma

If a true hyperprolactinoma is detected, the doctor gives a referral for the following types of studies:

• X-ray of the brain;
• blood chemistry;
• examination by an ophthalmologist;
• Magnetic resonance imaging of the pituitary gland.

Based on the test results, further treatment tactics are determined, which will include medical and surgical methods of therapy.

By determining the hormonal status of a woman, the amount of thyroid hormones is also determined, since hypothyroidism is one of the reasons for an increase in prolactin, and pregnancy in this case may also not occur.

Examination and treatment before pregnancy

Drugs that are prescribed in the following cases:

1. To inhibit tumor growth.
2. To neutralize damage to nerve tissue.
3. To reduce the symptoms of increased mammotropin.
4. For pregnancy due to a decrease in hormones.
5. To reduce adenoma during pregnancy.

The most important result of a woman using medications is to become pregnant. In advanced cases, when the threat to the patient’s life is higher in importance than her reproductive function, the issue of complex treatment is decided.

Medications

If not large sizes Pituitary adenoma, no measures are taken to remove it; it affects health minimally. Typically, the following means are used to lower the lactogenic hormone:

• licorice root syrup;
• infusion of cinquefoil;
• a product containing vitex extract.

If the tumor manifests itself with pronounced symptoms and becomes the cause of infertility, then the first thing to do is prescribe medicines ergoline or non-ergoline nature. These are the following drugs:

• Bromocriptine;
• Parlodel;
• Bromergon;
• Abergeen;
• Dostinex;
• Parlodel LAR.

The most commonly used drugs in the practice of reducing lactogenic hormone are Dostinex or Bromocriptine.

How to use Dostinex

With elevated prolactin, Dostinex has a prolonged effect, maintaining the effect even after its discontinuation. With normal prolactin levels, it not used.

For large prolactinomas, the drug should be taken for at least a year before trying to conceive. If the tumor is small, then drink it until the result is achieved.

If it is proven that it was the concentration of prolactin that influenced infertility, then after pregnancy occurs, stop taking the medicine.

Prognosis for women with hyperprolactinemia

Do not panic if luteotropin is elevated during a routine hormone test. With an increase in total lactogenic hormone, macroprolactinemia is possible, which does not affect the ability to have children.

Small increases in prolactin may subside when established healthy image life.

In other cases, drug treatment is used, in which in 80% of cases the pituitary gland responds with positive dynamics and mammotropin decreases.