High Prolactin Levels and Gynecomastia
What are High Prolactin Levels and Gynecomastia?
Gynecomastia refers to breast growth in men. Although this condition is often caused by benign factors such as eating habits and weight gain, it can also be caused by rare diseases that lead to high prolactin. Therefore, it should not be considered a simple aesthetic problem in men and should be investigated.
First, let’s learn about hormone called “Prolactine” that we often hear about.
What is Prolactin? What Causes High Prolactin Levels?
“What is prolactin, what causes high prolactin, what does high prolactin affect in men and women, and what should be the normal values?” Here is everything you need to know about the hormone prolactin:
What is Prolactin?
Prolactin is a hormone secreted from the pituitary gland. Prolactin, also known as the milk hormone, is abbreviated as PRL. The main task of this hormone is to mature the mammary gland from the 8th week of pregnancy in women. In this way, the pregnant women become ready for milk production. Prolactin hormone plays a role in sperm production in men. It is an important hormone for reproductive health in both men and women.
How is a Prolactin Test Done?
When your doctor decides for you to have a prolactin test, the first step is usually a blood test. It may take a few days for the test results to become available. The prolactin test measures the levels of prolactin in the body. However, there are some things to keep in mind before taking the test that may affect the levels of Prolactin Hormone;
- Use of birth control medications
- Use of certain high blood pressure medications
- Use of some antidepressants
- Sleeping disorders,
- Stress,
- Exhausting exercises before the test,
- Having sexual intercourse a few days before a prolactin test may affect the test results. Therefore, sharing this information with your doctor before the test is recommended.
In order to obtain the most accurate results in the prolactin test, it should be performed in the morning when the prolactin hormone level is the highest, as prolactin levels can change throughout the day.
Normal Prolactin Levels
The normal values of the prolactin hormone vary depending on gender. Additionally, pregnancy is another factor in determining the normal value of prolactin in women.
Normal Prolactin Levels in Women
Normal values of prolactin hormone in women generally range between 15-25 µg/L.
Prolactin levels increase in pregnant women in the later months of pregnancy. During these periods, the prolactin values of women may be much higher than normal.
Normal Prolactin Levels in Men
Normal levels of prolactin hormone in men generally range between 5-10 µg/L.
The table below shows the normal values of the prolactin hormone according to the genders and pregnant women.
In non-pregnant women | <<25 ng/mL |
In pregnant women | 34 – 386 ng/mL |
In men | <15 ng/mL |
What is High Prolactin?
High prolactin suppresses the production of FSH and GnRH hormones. Due to suppressed hormone production, egg production stops in women, leading to problems such as infertility and irregular periods. At the same time, high prolactin hormone lowers estrogen levels in women and testosterone levels in men. Decreased estrogen or testosterone levels can result in sexual problems.
What Are The Causes Of High Prolactin
If the prolactin hormone is not at its normal values and there is a high prolactin problem, the conditions that may cause this can be listed as follows:
- Eating disorder (Anorexia),
- Unbalanced diet,
- Antidepressants, opiate drugs, high blood pressure drugs, reflux drugs, epilepsy drugs,
- Some birth control pills,
- Kidney diseases and liver failure,
- Polycystic Ovary Syndrome,
- Insomnia and disturbed sleep patterns,
- Low thyroid hormone level (Hypothyroidism),
- Some systemic diseases,
- Tight underwears,
- Blow to the breast area,
- Pregnancy or breastfeeding,
- Sexual intercourse, stimulation of the nipples,
- Intense exercise,
- Prolactinoma (benign tumor in the pituitary gland)
However, your specialist doctor’s opinions are significant to determine the causes of your prolactin levels.
What Does High Prolactin Affect? What Are The Symptoms?
To determine if you have high levels of prolactin, you can look for symptoms that result from high levels. The following are symptoms caused by high levels of prolactin:
- Inability to become pregnant,
- Breast tenderness,
- Irregular menstruation,
- Sexual aversion,
- Absence of menstruation,
- Headaches,
- Vision problems,
- Menopause symptoms (such as vaginal dryness and hot flashes),
- Milk secretion from breasts.
Effects of High Prolactin in Men
High levels of prolactin are problematic in men. These problems are:
- Breast growth (gynecomastia),
- Breast tenderness,
- Visual disturbances,
- Decreased testosterone levels,
- A sudden decrease in body hair,
- Growth of breasts,
- Premature ejaculation,
- Sexual aversion,
- Decrease in sperm quality,
- Softening of testicles,
- Erectile dysfunction,
- Headaches,
- Infertility,
- Although it is an infrequent symptom, it can cause nipple discharge.
Treatment of High Prolactin
How is the Treatment of High Prolactin?
After the cause of high prolactin is determined, a treatment method is chosen. When an increase in prolactin hormone is observed, medicine treatments called dopamine agonists are generally applied. However, some lifestyle changes you can make may also be beneficial in treating high prolactin. These changes include:
- Choosing comfortable underwear for the chest area,
- Avoiding heavy work,
- Staying away from stress,
- Avoiding excessive exhaustion of the body,
- Consuming foods containing B6 and E vitamins.
If the prolactin level does not decrease despite the precautions you take and the medications you use, and if no shrinkage is observed in the prolactinoma, the tumor, your doctor may prefer surgery. The operation is performed open or closed depending on the size and spread of the tumor. Closed surgery with the endoscopic method is preferred when the tumor is small and has not spread. The problematic area is treated by entering the patient’s nasal cavity. The healing process of closed surgery is fast and does not leave any scars on the patient.
However, if the tumor is large and has spread to the brain tissue, it requires transcranial surgery. In open surgery, the tumor is reached from the upper part of the skull. The healing process is longer, with higher risks and complications than closed surgery. After the surgery, the problem of high prolactin levels disappears in many patients.
What Is Low Prolactin, and How Is It Treated?
When the prolactin hormone falls below normal levels, it is called low prolactin. Reasons for low prolactin include:
- Excessive dopamine secretion in the body,
- Insufficient hormone secretion from the pineal gland,
- Some immune system diseases,
- Some medications (Levodopa, Dopamine, Ergot Alkaloid, etc.),
- Insufficient growth hormone.
Low Prolactin,
In women,
- Insufficient milk production,
- Decreased ovarian function.
In men,
- Erectile dysfunction,
- Premature ejaculation.
The first step in treating low levels of prolactin is to investigate the underlying cause. Based on this investigation, it is necessary to avoid negative factors that may cause the deficiency and seek the help of an expert for dietary recommendations.