Causes of Elevated Prolactin Levels in Women

Causes of Elevated Prolactin Levels in Women

Elevated prolactin levels are identified when laboratory tests show concentrations exceeding the normal range for women, which are defined as follows:

• For non-pregnant women: less than 25 micrograms per liter.
• For pregnant women: 80 – 400 micrograms per liter.

While increased prolactin levels during pregnancy and recent childbirth are considered normal, it can also indicate underlying health issues that warrant consultation with a healthcare professional. Notable causes of elevated prolactin levels include both natural and pathological conditions:

Increased Prolactin During Pregnancy

Elevated prolactin levels during pregnancy are a common phenomenon, with levels rising 10 to 20 times higher than those of non-pregnant women. Prolactin levels can fluctuate throughout the day due to various factors, reaching their peak under the following conditions:

• Physical stress.
• During sleep.
• Immediately after waking up.
• Emotional stress.

Increased Prolactin During Breastfeeding

Prolactin naturally peaks immediately after the placenta is expelled following childbirth, attributed to a sudden drop in estrogen and progesterone levels. Prolactin signals the breast glands to initiate milk production, reaching approximately 100 micrograms per liter by the seventh day of breastfeeding.

After several months of nursing, prolactin levels gradually decrease. It is crucial to continue breastfeeding or pumping milk to maintain production, as discontinuing breastfeeding can lead to reduced prolactin levels and eventual cessation of milk production.

Increased Prolactin Due to Medical Conditions

Certain medical conditions can lead to elevated prolactin levels. Although high prolactin may not pose immediate risks, it can be a sign of more serious health issues. Significant conditions associated with increased prolactin include:

Prolactinoma

Prolactinoma is a benign tumor of the pituitary gland that results in excess prolactin secretion.

Hypothyroidism

In cases of hypothyroidism, the pituitary gland increases the production of Thyrotropin-releasing hormone (TRH), which in turn raises prolactin levels. It is important to note that while prolactin levels may be elevated, they are typically lower than those observed in prolactinomas.

Anorexia Nervosa

Anorexia nervosa, an eating disorder characterized by an intense fear of gaining weight, has been shown to disrupt pituitary function, leading to increased hormone secretion, including prolactin, among affected women.

Increased Prolactin Due to Stress

Excessive stress and anxiety can elevate prolactin levels in non-pregnant women. Stress affects the pituitary gland, which is responsible for prolactin secretion, as well as the hypothalamus, which regulates pituitary outputs, resulting in increased prolactin production.

Increased Prolactin from Intense Physical Activity

Over-exercising can lead to heightened prolactin levels. Studies have indicated that prolactin measurements taken immediately after moderate to intense exercise can show increased levels, although they typically return to baseline within 24 hours post-activity. Prolactin levels remain stable with prolonged exercise routines.

Increased Prolactin as a Side Effect of Certain Medications

Some medications can cause elevated prolactin levels as a side effect. Notable drug categories contributing to this condition include:

• Antipsychotics such as Haloperidol and Risperidone.
• Antidepressants like Clomipramine.
• Antiemetics such as Metoclopramide and Domperidone.
• Antihypertensives like Methyldopa.

It is advisable to consult with a healthcare provider to ascertain whether the prescribed medication may be responsible for elevated prolactin levels and to determine if an alternative treatment is necessary.

Increased Prolactin from Herbal Supplements

The use of certain herbal remedies may lead to increased prolactin levels. It is always recommended to consume such herbs under professional guidance to avoid unwanted side effects. Some herbs implicated in raising prolactin include:

• Fenugreek: Contains phytoestrogens, which can elevate prolactin levels.

Fennel: Known for its natural components that may also boost prolactin levels.

• Anise: Although it contains anethole, a natural phytoestrogen, scientific evidence confirming its effect on prolactin is still lacking, necessitating further research.

Increased Prolactin Due to Chest Wall Irritation

The chest wall protects vital organs such as the heart, liver, and lungs. Irritation of the chest wall from certain conditions can elevate prolactin levels in women. Common causes of chest wall irritation include:

• Infections from bacteria, viruses, or fungi.
• Trauma or injuries.
• Tight-fitting bras.
• Surgical procedures.

Risk Factors for Elevated Prolactin Levels in Women

In addition to the aforementioned causes, other factors can heighten the risk of elevated prolactin levels in women, such as:

• Sore or cracked nipples.
• Kidney failure.

Notably, gender plays a crucial role in the prevalence of elevated prolactin levels, with women being more susceptible than men.

Symptoms of Elevated Prolactin Levels in Women

Elevated prolactin can significantly impact a woman’s daily life, manifesting through symptoms such as:

• Headaches.
• Nipple discharge.
• Milk production without pregnancy or recent childbirth.
• Vision changes.
• Infertility.
• Premature menopause.

Conclusion

Multiple factors contribute to elevated prolactin levels, with some being natural, such as during pregnancy and breastfeeding, while others may signal serious health issues. Additionally, the use of certain medications and herbal treatments can influence prolactin levels. It is also essential to recognize that women are more vulnerable to elevated prolactin levels compared to men.