Abnormal prolactin levels can cause infertility, lactation, low sex drive, and other symptoms. High levels can be caused by a tumor, kidney disease, or medication, while low levels can be caused by pituitary dysfunction or other diseases. MRI tests can detect tumors.
Abnormal prolactin levels can be too high or too low, although most commonly they are too high. The scale for this test varies by laboratory, but abnormal prolactin levels for a male are typically less than 2 nanograms per milliliter (ng/mL) of blood or greater than 18 ng/mL. For a non-pregnant, non-lactating woman, abnormal levels are typically less than 2 ng/mL or greater than 29 ng/mL. Abnormal levels for a pregnant woman are usually below 10 ng/ml or above 209 ng/ml. This is usually the same for breastfeeding women, but after about a week, postpartum, levels begin to decline and continue to decline throughout breastfeeding the less a baby nurses.
Prolactin is the hormone produced by the pituitary gland and is responsible for lactation. Men, non-pregnant and non-breastfeeding women also produce this protein hormone, although the reason is unknown. Prolactin is also known as the luteotropic hormone. An abnormal level of prolactin can cause a variety of symptoms, including infertility. Other symptoms of abnormal prolactin levels include postpartum non-induced lactation, low sex drive, erectile dysfunction, and amenorrhea.
Although the symptoms of an abnormal prolactin level can interfere with aspects of life such as conceiving a child, the cause of an elevated prolactin level is sometimes quite serious. For example, an extremely high level of luteotropic hormone – more than 200 ng/ml – can be the result of a prolactinoma, a tumor located in the pituitary gland. Other conditions that cause a high prolactin level include idiopathic hyperprolactinaemia, hypothyroidism, kidney disease, nerve damage, and cirrhosis. Some medications, especially some antipsychotics, can also cause an abnormal level of prolactin.
An increase in prolactin could mean that a woman has ovarian cancer. After an elevated prolactin level is found, the next test done is a magnetic resonance imaging (MRI) test, which can detect if there is a tumor in the pituitary gland. If there is no tumor, conducting further tests is the next step.
In some cases, a prolactin deficiency occurs. This condition is usually secondary to anterior pituitary dysfunction. Postpartum pituitary necrosis or Sheehan syndrome account for the majority of cases of prolactin deficiency. Other causes of a prolactin deficiency could include anterior pituitary impairment, parasellar disease, hemochromatosis, sarcoidosis, and tuberculosis.
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