Excessive prolactin levels can cause infertility and menstrual irregularities:
Hyperprolactinemia is a common cause of ovulatory abnormalities and infertility in women. Even mild elevations can interfere with luteal function and menstrual regularity, leading to infertility and irregular periods.
Once pregnancy is achieved, the brain activates prolactin secretion, increasing milk production while suppressing estrogen production and ovulation. This is why hyperprolactinemia is a major cause of infertility.
Excessive prolactin levels can cause amenorrhea and galactorrhea in women, and can also lead to testicular insufficiency in men, resulting in sexual dysfunction and infertility. Therefore, hyperprolactinemia can affect the reproductive function of both men and women.
Normal prolactin levels should be:
Women: < 25 ng/ml
Men: < 20 ng/ml
Exceeding the following values may indicate reproductive abnormalities:
60–70 ng/ml: Possible progesterone deficiency, leading to poor implantation or recurrent miscarriage
>100 ng/ml: Commonly associated with menstrual cycle irregularities or amenorrhea
>200 ng/ml: Highly suspected prolactinoma, requiring further MRI examination
Causes of elevated prolactin:
1. Excessive stress
2. Poor sleep quality
3. Pituitary prolactinoma
4. Hypothyroidism
5. Polycystic ovary syndrome (PCOS)
6. Chronic kidney disease, liver disease
7. Medications that affect prolactin levels (antipsychotics, antidepressants, oral contraceptives, antihypertensives, analgesics, estrogen)
Clinical manifestations of elevated prolactin:
1. Menstrual cycle irregularities or amenorrhea
2. Ovulatory disorders
3. Infertility
4. Poor luteal phase function (leading to implantation difficulties)
5. Galactorrhea (milk secretion despite not being pregnant or breastfeeding)
6. Decreased libido
7. Depression
Stress can lead to elevated prolactin levels:
Excessive stress is a common cause of elevated prolactin levels (hyperprolactinemia), especially in women with infertility. Stress affects the body's nervous system, which in turn affects the secretion of the pituitary gland, including prolactin. High prolactin levels due to stress are quite common among women seeking medical attention for infertility.
Mild prolactin elevations can be alleviated through appropriate stress reduction and lifestyle adjustments (regular exercise, adequate sleep, diet control, etc.), and do not necessarily require medication. If relief from stress does not improve, or if symptoms such as menstrual irregularities or infertility occur, seek medical attention promptly to identify the underlying cause and seek treatment.
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