High prolactin levels: a common cause of infertility

High prolactin levels: a common cause of infertility

High prolactin levels: a common cause of infertility

There is a common cause of infertility in women: an excess of a particular hormone called prolactin, which is responsible for about 20% of female infertility and which can be treated effectively and quite simply. Prolactin is a hormone secreted by the pituitary gland in both men and women. It is known for its key role in the initiation and maintenance of lactation and the growth of the mammary glands. It also acts on the secretion of progesterone in women and testosterone in men and plays a role in the functioning of the libido. If there is an excessive secretion of prolactin, it is called hyperprolactinemia.

Which are the normal prolactin levels?

The results of prolactin levels vary from laboratory to laboratory, but in general the normal level is between 5 and 20 ng/mL, and it can reach 250 ng/mL in late pregnancy. Although standards vary from laboratory to laboratory, it is between 1 and 15 nanograms/mL after the menopause. The reference values with another measurement unit are 100 to 500 mIU/l in women, and 85 to 325 mIU/l in men. The pathological threshold is 900 mIU/l. Sometimes the test is repeated to confirm the result in an experienced laboratory.

What is the cause of this pituitary gland disorder?

There are several causes. There may be a small, benign tumor called a pituitary adenoma. In the past, it was treated by surgery through the nose, in fact by going behind the nasal cavity without opening the skull, under visual control thanks to a binocular magnifying glass. Today, much more often, when the adenoma is small and does not threaten the nerves of vision, which is the usual case, a treatment with tablets is prescribed (often only one tablet per week). This treatment causes the adenoma to shrink and often disappear, the flow of milk stops, menstruation returns, indicating ovulation and the return of fertility.

The consequences of hyperprolactinemia on fertility

The increased prolactin level in the blood decreases the secretion of gonadotropins, the hormones that stimulate the sex cells. The consequences of hyperprolactinemia differ according to gender. In women, it leads to ovulation disorders, sometimes resulting in the complete disappearance of ovulation. Men suffer from erectile dysfunction and a reduced libido and sometimes gynecomastia, i.e. the appearance of breasts. In both men and women, milk flow (or galactorrhea) from the nipple is possible.  Thus, because it affects the reproductive organs, hyperprolactinemia can lead to fertility problems, reduced libido and amenorrhea.

Is there not a risk of a relapse of the pituitary tumor in the event of pregnancy?

Yes, there is. It is necessary to monitor during the pregnancy (obtained thanks to this treatment) if headaches or visual problems occur which would lead to the resumption of the treatment, and in rare cases to surgery.

It is important to remember that in the case of infertility in a couple, examining the breasts for spontaneous discharge or discharge under pressure, and a simple hormonal dosage can lead in one case out of five to a fairly simple treatment and a pregnancy. Medimall experts can help you with the necessary checks on your prolactin levels.


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