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High prolactin levels can be associated with organ damage and infertility. If a hormone test identifies an unusually high concentration of this hormone, it is important to find out why and to provide an appropriate treatment. Usually an endocrinologist is involved in the diagnosis and treatment of patients with high prolactin, although treatment may also require input from gynecologists, fertility specialists, and other medical providers.
Prolactin is a hormone produced by the pituitary gland to stimulate milk production. In healthy individuals who are not pregnant or breastfeeding, the concentrations of this hormone should be low, as the body suppresses prolactin production. In pregnancy and breastfeeding, levels start to rise, triggering lactation and maintaining a steady supply of milk.
For women, high prolactin can result in interruptions to the menstrual cycle and ovulation. These may lead to infertility. Some women develop menopausal symptoms due to their hormone imbalances and also tend to experience a low sex drive. There is also a higher risk of osteoporosis with higher than normal prolactin levels. Some women develop polycystic ovaries, which can lead to future fertility problems as well as pain in the abdomen.
Men and women can develop liver and kidney damage if their hormone levels are interrupted for an extended period of time. Men with high prolactin may notice increased breast tenderness, secretions from the breasts, low sex drive, and decreased fertility. The hormone can reduce sperm motility and make it more difficult to achieve and sustain an erection. Men may also feel more sluggish as a result of the rise in prolactin in their bloodstream.
Patients commonly get tested for abnormal hormone levels as part of a routine fertility workup if they have difficulty getting pregnant. A doctor may also order testing if a patient appears to have symptoms of hormone imbalances like hot flashes, fatigue, and warning signs of organ damage like frequent thirst and urination in patients with kidney problems.
Tumors known as prolactinomas are a common cause for elevated levels of this hormone. A doctor can run some diagnostic tests to find out more about the patient's hormone levels and decide on the best course of treatment. Often, medications are sufficient to bring levels back down to normal. Sometimes the patient needs surgery to take the tumor out, if it does not respond to medication or appears to be causing complications like continued interruptions to hormone production as a result of pressure on the pituitary gland. It is important for patients to get treatment even if they are not concerned about fertility, as high prolactin levels can cause problems with other systems in the body, especially if they become chronic.