By Dr. Rut Gómez de Segura (Gynaecologist – Reg. No. 28/2908776).
Prolactin is a hormone that, although often primarily associated with lactation, plays a crucial role in many other bodily processes, including fertility. Changes in its levels can significantly affect reproductive capacity in both women and men.
It is produced by the pituitary gland, a pea-sized gland located at the base of the brain. Its most well-known function is to stimulate breast milk production after childbirth. However, it also plays a role in other physiological functions such as regulating the immune system, metabolism, and, most importantly, reproductive hormonal balance.
Generally, normal blood levels of prolactin range between 4.8 and 23.3 ng/mL in non-pregnant women, and up to 300 ng/mL in pregnant women. In men, normal levels range between 4.0 and 15.2 ng/mL. However, these values can vary depending on the menstrual cycle phase or other factors such as stress, sleep, or even physical exercise.
Hyperprolactinemia is a medical condition in which blood levels of prolactin are above the normal range. It is a fairly common hormonal disorder and can be associated with physiological, pharmacological, or pathological causes.
This excess of prolactin can lead to menstrual irregularities or even absence of menstruation (amenorrhea), decreased libido, and infertility. In men, it may manifest as erectile dysfunction or gynecomastia (enlargement of breast tissue), and can also cause infertility.
The causes of hyperprolactinemia are varied:
On the other hand, there are also pharmacological and pathological causes. Some medications, such as antidepressants, antipsychotics, antihypertensives, and hormonal contraceptives, can increase prolactin as a side effect.
Among the pathological causes, the most notable are:
To diagnose hyperprolactinemia, a blood test is needed to measure prolactin levels. When elevated values are detected, it is important to repeat the test and rule out temporary factors.
In other cases, additional tests such as brain MRI to evaluate the pituitary gland, or hormonal and thyroid function studies, may be performed. To determine the appropriate treatment, medical professionals must clearly identify the underlying causes of the condition. Typically, dopaminergic medications are prescribed to reduce prolactin production. If the condition is caused by diseases or tumors, surgery or specific treatments may be considered to eliminate the cause.
In cases of high prolactin, the hormonal axis that regulates the menstrual cycle and ovulation can be affected. This can inhibit the secretion of GnRH (gonadotropin-releasing hormone), reduce LH and FSH levels, and even block or alter ovulation. All of this can make it difficult or even impossible to achieve pregnancy.
In men, hyperprolactinemia can reduce testosterone and sperm production, potentially affecting male fertility. Therefore, it is clear that hyperprolactinemia can impact the ability to conceive, both naturally and through assisted reproductive treatments. That’s why it is essential to detect and treat it properly. In many cases, simply normalizing prolactin levels can restore ovulation or sperm production.
The Endocrine Society.
Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline.
The Endocrine Society.
2011;
The Journal of Clinical Endocrinology & Metabolism. 96(2):273-288
Clinical practice guideline (full text):
https://academic.oup.com/jcem/article/96/2/273/2709487
Kaiser UB.
Hyperprolactinemia and infertility: new insights.
American Society for Clinical Investigation (ASCI).
2012;
The Journal of Clinical Investigation. 122(10):3467-3468
Scientific article (full text):
https://pmc.ncbi.nlm.nih.gov/articles/PMC3461927/
Samperi I., Lithgow K., Karavitaki N.
Hyperprolactinaemia.
MDPI.
2019;
Journal of Clinical Medicine. 8(12):2203
Review article (full text):
https://pmc.ncbi.nlm.nih.gov/articles/PMC6947286/
Iancu ME., Albu AI., Albu DF.
Prolactin Relationship with Fertility and In Vitro Fertilization Outcomes. A Review of the Literature.
MDPI.
2023;
Pharmaceuticals. 16(1):122
Review article (full text):
https://pmc.ncbi.nlm.nih.gov/articles/PMC9867499/
Privacy Policy
IVF-LIFE, hereby informs you of its privacy policy applied to personal data. The use of the website does not imply that the user must provide any information regarding their identity, and cannot be associated with a specific user by the company. In the event that personal data is provided, this data will be collected and used in accordance with the limitations and rights set out in the aforementioned regulation.
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