 High Prolactin Level: Impact On Female Sexual Health
Prolactin: Prolactin is a protein secreted by on brain's pituitary gland, breast and uterus lining(decidua).Prolactin has role in breast milk production as well as its level rises after sexual intercourse and lead to sex satisfaction and relaxation.Prolactin has many other non-sexual functions too. Prolaction Role In Brest Milk Production: During pregnancy high levels of prolactin are maintained by another female sex hormone(estrogen) however its function as milk producing hormone is inhibited by another hormone progesterone. Due to its high level during pregnancy it causes enlargement and development of breast glands. After delivery estrogen and progesterone level fall and also of prolactin for a while. As soon as baby suckle on breast nerve signal goes to brain and causes prolactin secretion that cause milk production. HperProlactenemia: Increased prolactin level: Increased prolactinlevel may cause hot flushes , galactorrhea (inappropriate milk secretion) ,vision problem , decreased libido (sex drive). Elevated prolactin levels (called hyperprolactinemia) may interfere with ovulation and menstrual cycle regularity. Causes: 1)Drugs like anti psychotic medication 2)thyroid problem 3)liver and kidney disease 4)pituitary gland tumor 5)Breast stimulation,sex and pelvic exam may temporarily increase levels. 6)Stress Whenever there is increased prolactin in blood brain try to inhibit it fuction by another hormone secretion that is dopamine from hypothalamus(structure in brain).This hormone,dopamine,acts on pituitary and inhibits prolactin secretion. If however this mechanism cannot fuction like there is underlying medical condition or drug intake level of both prolactin and dopamine will be high.This high level of dopamine inhibit another hormone GnRH that effect ovarian fuction.Also high prolactin level effects FSH. What Are Normal Level Of Prolactin: According to WHO females upper linit be upto 29ng/dl or 700pmol/l.However different laboratories used different hormone standard so test result must be compared with the lab standard range Management: Low level of prolactin or mildly increased level without symptoms or infertility are not treated as such. Pharmacological: Dopamine agonist drugs are used that increase dopamine activity and so inhibit prolactin action and cure symptoms. There is an older generation and a newer generation of these drugs. For How Long Drug Is To Be Taken? Older generation: starting from minimum dose for 1week continuously drug is given once or twice daily. Level are monitored after 1week if not decreasing then dose is increased.Otherwise maintainance dose is give until the female Conceives (till Pregnancy) Newer generation drugs are given 0nce or twice a week. Depending on levels max in 3-8week levels reach normal Other Treament Options: If there is an under lying reason that is to be treated. 1)if drugs are causing high prolactin level they are to be replaced by other drugs 2)If there is pituitary adenoma(cancer) depending on size its managed
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