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Prolactin is a hormone occassionally overproduced by the brain, interfering with
normal reproductive function.
Hyperprolactinemia
Prolactin is a hormone secreted by the pituitary gland (located at the base of the
brain). Normally, prolactin is present in the blood stream in low levels in nonpregnant
women. During pregnancy, prolactin levels increase approximately ten-fold and stimulate
milk formation. Hyperprolactinemia is a condition where the brain secretes too much
prolactin in a woman who is not pregnant. Hyperprolactinemia can produce a variety
of reproductive dysfunctions including inadequate progesterone production during
the luteal phase after ovulation, irregular ovulation and menstruation, absence
of menstruation, and galactorrhea (breast milk production by a woman who is not
nursing).
Prolactin levels should be measured in women who experience these conditions. Prolactin
secretion may increase mildly with sleep, stress, intercourse, exercise, nipple
stimulation, ingestion of certain foods and drugs, and pregnancy. If a woman's prolactin
level is elevated the first time it is tested, a second sample should be checked
when she is fasting and non-stressed. If the prolactin level continues to be markedly
elevated, it is important to look for a cause.
Ovulation and menstruation generally return within six weeks of normalizing prolactin
levels. Galactorrhea takes more time and is less certain to resolve.
Hyperprolactinemia is a common problem found in up to one-third of patients with
absence of menstruation and in up to 90 percent of women with galactorrhea. Observation
and expectant management is appropriate for some of these women, and medical management
is highly successful in others.
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