Things To Know About Hyperprolactinemia
Written by Munirah Yaqoub
Caveat: This article doesn’t serve as expert medical advice. It is important to consult your doctor when you notice something is off with your body.
Hi there, it’s your friendly neighborhood, not-a-doctor, health columnist reporting for duty and ready to inform you about another health condition. This particular condition affects both men and women, but our focus will be on the women because… well, it is what it is. Picture this: you’re doing your monthly breast examination when you notice a white or milky discharge from your breasts. You’re scared because you’ve heard that nipple discharge is one of the symptoms of cancer. You book an appointment with your doctor, tests are carried out, and you’re later informed that you’re lactating. “But doctor, I’m not pregnant” would be your first response.
Hyperprolactinemia (pronounced “hai-par-pro-lak-t-ni-mi-a”), as the name suggests from the use of the word “hyper,” simply means a situation where your body is producing way more prolactin than it needs. Prolactin is the hormone produced by the pituitary gland, whose main function is to cause the breasts to grow and stimulate breast milk production after childbirth. Other functions of prolactin in women include the regulation of the menstrual cycle as well as the regulation of sex hormones (estrogen and testosterone).
Hyperprolactinemia is quite normal in pregnant women. However, for non-pregnant women, it is a sign of an underlying problem. Hyperprolactinemia is relatively common in women. According to the American Society for Reproductive Medicine, about one-third of women in their childbearing years with irregular periods but normal ovaries have hyperprolactinemia. Normal prolactin levels for non-pregnant women range from 2–29 nanograms per milliliter (ng/mL). So, when your prolactin levels are higher than that, you can rightly be said to have HPL (I claim full rights over the word “HPL”, so please don’t use it unless you’re ready to pay me my coins).
So, how can you tell when you have HPL? Well, symptoms usually differ and are sometimes totally absent, which makes it difficult to diagnose and treat on time. However, common symptoms of HPL include infertility, long or irregular periods, change in menstrual flow, pause in the menstrual cycle, loss of libido, lactation (galactorrhea), breast pain, vaginal dryness, anovulation (when an egg is not released during a menstrual cycle), absence of periods, abnormal hair growth, headaches, blurred vision, etc. If you’re experiencing any of these symptoms, it is very important that you consult your doctor for early detection and treatment.
Blood tests (medically termed “hormonal profile tests”) are usually carried out to measure your prolactin level. If a person tests positive for hyperprolactinemia but has no symptoms, the test may be picking up macroprolactin (prolactin molecules that are larger than normal). This form of prolactin affects the body differently, so management and treatment may or may not differ, depending on the situation. If prolactin levels are high, more tests are done to determine the root cause. These tests include the blood levels of the thyroid hormone (which would either confirm or rule out hypothyroidism), magnetic resonance imaging (MRI) to confirm or rule out a pituitary tumor or damage to surrounding tissues, liver tests, etc. Where no clinical cause is found, then it may or may not be difficult to treat. All these sound scary, don’t they? But, rest easy. I’ll tell you why soon enough.
Now that we know what to look out for to determine if we have HPL, let’s consider its causes. The most common cause of HPL is prolactinoma, which is a growth or tumor on the pituitary gland and is usually non-cancerous. Other causes of HPL include hypothyroidism (underactive thyroid), pregnancy, use of certain medications (usually given for high blood pressure, depression, heartburn, nausea and vomiting, pain, birth control pills, menopausal symptoms, etc.), herbs (including fenugreek, fennel seeds, and red clover), irritation of the chest wall (from surgical scars, shingles, or tight bras), certain foods, nipple stimulation, liver or kidney diseases, extreme stress, or exercise. However, there are times when no cause for HPL is found, usually in about a third of all cases.
Unmanaged HPL can impact fertility and bone density, leading to osteoporosis (a health condition that weakens the bones, making them fragile and more likely to break). However, remember when I told you not to fret? The good news is that HPL is generally treatable, and treatment depends on the cause of the excess secretion. Early diagnosis and treatment can help reduce the risks and complications associated with this condition. Where the underlying cause is a tumor, treatment usually includes prescription medicines (dopamine agonists like Bromocriptine and Cabergoline decrease prolactin production), surgery to remove the tumor (where medicines are ineffective), and radiation to shrink the tumor (where neither medicine nor surgery is effective).
Caveat: This article doesn’t serve as expert medical advice. It is important to consult your doctor when you notice something is off with your body.
Hypothyroidism is usually treated with synthetic thyroid hormone to bring the prolactin levels back to normal. Where medication is the cause, alternative types of medication are explored. Where no cause is found, the treatment is usually medication. It is important to note that not all women with hyperprolactinemia need treatment, although women who do not make estrogen, as a result, need a treatment that either causes them to make estrogen or provides estrogen to the patient. No treatment may be needed if a cause can’t be found or if the high prolactin level is due to a small tumor in the pituitary gland and the patient is still making estrogen. Women with hyperprolactinemia can still take birth control pills to keep them from getting pregnant or to make their periods regular.
I must say that this article doesn’t serve as expert medical advice. It is important to consult your doctor when you notice something is off with your body. Questions to ask your doctor include: “
What is the cause of my hyperprolactinemia?”
What tests do I need to be carried out?
What are my treatment options?
What are the complications of my condition?
Key Things to Note:
Prolactin is a hormone that is most known for stimulating lactation (breast milk production), but it’s also involved in functions including ovulation, reproduction, immunity, and blood cell formation.
Hyperprolactinemia is a condition where there is an abnormally high amount of prolactin in the body.
People with hyperprolactinemia may experience irregular or absent menstrual periods, abnormal breast milk discharge, infertility, and sexual side effects.
Hyperprolactinemia is generally curable and conditions begin to get better after treatment.
The word “HPL” is my thing. Don’t go and tell your doctor you have HPL. They won’t know what it means, and I will find you and have you run me my coins.
Munirah Yaqoub is a law graduate who is passionate about women and children’s rights. You can connect with her on Instagram and Twitter.
Edited by Oluwatobiloba Ganiyu
Female, Editor, Medical student, ambivert, goofball, Christian. Always interested in learning new things. Connect with Oluwatobiloba on Instagram.
Published by Akinsipe Temitope
Temitope is a young storyteller who thinks all stories are worth telling. She loves to inspire people to do what they love and follow their passions, tell their stories, and live in the present moment. Connect with Temitope on Instagram, and Twitter.
More from Sisterly HQ
