What are the causes and symptoms of high prolactin levels?

Apr 18, 2023 Source: Cainiu Health

Dr. Yang Ziqi

Introduction

In general, high prolactin levels may be caused by factors such as physical exercise, improper use of medications, hypothalamic disorders, primary hypothyroidism, or polycystic ovary syndrome. Common symptoms include visual disturbances, galactorrhea (milk secretion from the breasts), menstrual irregularities, dizziness, and infertility. Patients are advised to maintain a balanced diet and avoid spicy or irritating foods to prevent worsening of the condition.

Elevated prolactin levels are generally caused by factors such as physical exercise, improper use of medications, hypothalamic disorders, primary hypothyroidism, or polycystic ovary syndrome (PCOS). Common symptoms include visual disturbances, galactorrhea (milk secretion from the breasts), menstrual irregularities, dizziness, and infertility. The detailed analysis is as follows:

I. Causes

1. Exercise

Intense physical activity or exercise may trigger a stress response in the body, activating the pituitary-hypothalamic-mammary axis. In this case, the body's prolactin-releasing factors increase, thereby stimulating the pituitary gland to secrete more prolactin. This is a normal physiological phenomenon and does not require specific treatment.

2. Improper Medication Use

Certain medications or misuse of drugs may lead to elevated prolactin levels. For example, antipsychotics, antidepressants, and antihypertensive drugs may interfere with the normal regulation of the pituitary-hypothalamic-mammary axis, resulting in increased prolactin release. Prolactin levels typically return to normal after discontinuation of these medications.

3. Hypothalamic Disorders

Prolactin is a hormone secreted by the pituitary gland. Conditions such as encephalitis or localized infarction of the hypothalamus can reduce inhibitory control over prolactin secretion while increasing prolactin-releasing factors, leading to elevated prolactin levels. Patients may be treated under medical supervision with medications such as Compound Valerate Estradiol Tablets orProgesterone Capsules.

4. Primary Hypothyroidism

This condition results in insufficient thyroid hormone production. The body signals this deficiency to the hypothalamus, causing stimulation that increases thyrotropin-releasing hormone, which in turn promotes prolactin secretion. Patients may be treated under medical guidance with medications such as Levothyroxine Sodium Tablets or Thyroid Tablets.

5. Polycystic Ovary Syndrome (PCOS)

PCOS is a common endocrine disorder characterized by the formation of multiple ovarian cysts and elevated androgen levels. These hormonal imbalances may disrupt the normal regulatory mechanisms of the pituitary-hypothalamic-mammary axis, leading to increased prolactin levels. Patients may be treated under medical supervision with medications such as Progesterone Capsules or Dydrogesterone Tablets.

II. Symptoms

1. Visual Disturbances

Excessive prolactin secretion may cause enlargement of pituitary adenomas, which can compress brain tissue and nerves, obstruct cerebrospinal fluid circulation, and result in symptoms such as dizziness and blurred vision.

2. Galactorrhea

Prolactin is a hormone that primarily stimulates breast cells to produce and secrete milk. When prolactin levels are abnormally elevated, it may overstimulate breast cell activity, leading to milk secretion from the breasts. While this is common during lactation, galactorrhea occurring outside of breastfeeding periods—or in males—may indicate hyperprolactinemia.

3. Menstrual Irregularities

Elevated prolactin levels can interfere with normal signaling between the pituitary gland and ovaries. As the pituitary releases excess prolactin, it disrupts signals that stimulate ovarian follicle development and estrogen production. This may lead to ovarian dysfunction, impair follicular development, and disrupt the normal menstrual cycle, resulting in irregular menstruation and anovulation.

4. Dizziness

Elevated prolactin levels may affect the central nervous system, including vascular regulation and neural transmission, potentially causing symptoms such as dizziness, vertigo, or low blood pressure. Some individuals may experience these discomforts when prolactin levels are high.

5. Infertility

Abnormally high prolactin levels can suppress ovulation, potentially leading to female infertility. In pregnant women, it may also increase the risk of miscarriage.

Patients are advised to maintain a balanced diet and avoid spicy or irritating foods to prevent worsening of their condition.

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