A blood test for prolactin determines the content of a hormone that is extremely important for bearing and breastfeeding a child. To obtain the most accurate results, it must be taken on certain days of the ovulatory cycle.

When to take it

Conducting an analysis of the concentration (lactotropin, lactotropic hormone) in a woman’s body is necessary to determine her ability to carry and breastfeed a child normally. A deviation of hormone levels from the norm indicates that a woman has a certain disease or pathological condition. However, there are cases when deviations are caused by physiological (natural) reasons, then there is no cause for concern - the condition returns to normal in a short time.

Every woman should know on what day of the cycle they donate blood to determine prolactin levels. This is due to the fact that this analysis itself is quite complex and the likelihood of obtaining false results when testing blood taken at the wrong time is very high. Although in laboratories equipped with advanced diagnostic equipment (which not all medical institutions have), the likelihood of obtaining an erroneous result is lower.

According to the recommendations of the international medical community, a test to determine the level of prolactin in the blood should be taken on the 3rd – 5th day of the start of the menstrual cycle. If it is not possible to draw blood at this time, you can take the test on days 23-26 of the ovulatory cycle.

Taking material on any other day is strictly not recommended, since the likelihood of obtaining a false result increases significantly. This is due to the course of hormonal processes in the female body.

An exception is the study of lactotropin levels in pregnant women. They can submit material any day. This is due to the fact that the level of the hormone in their body is stable. The result of a study of prolactin content in a pregnant woman, first of all, shows the woman’s ability to fully bear a child and breastfeed it. Whereas the analysis in a non-pregnant woman is aimed at determining the current state of her reproductive and endocrine systems.

Attention! The information provided concerns the average length of the menstrual cycle for most women, 29 days. If the duration of your ovulatory cycle differs from the average, we recommend that you consult your gynecologist or endocrinologist. Only he knows exactly when, in this case, blood is donated for analysis.

Explanation of the choice of the specified time

In accordance with the generally accepted point of view of gynecologists and endocrinologists, days 3-5 and 23-26 are the most favorable for laboratory testing. This is explained by the cyclical change of phases of the ovulatory cycle, during which a change in the concentration of the hormone in the blood of women is observed. We present the features of changes in hormonal levels in accordance with the periods of the menstrual cycle.

Period (phase) of the cycle	Duration of the period and normal prolactin levels
Follicular	The beginning of the phase is considered to be the day of the onset of a new ovulatory cycle. This period is characterized by prolactin levels of 4.5-33 ng (nanograms)/ml.
Ovulatory	The duration of the period is approximately 3-4 days. The beginning is considered to be 1-3 weeks after the onset of menstruation. At this time it fluctuates at the level of 6.3-49 ng/ml.
Corpus luteum (luteal)	It begins immediately after the cessation of ovulation and lasts 14 days. At this time, an increase in the concentration of female hormones is characteristic. The likelihood of pregnancy increases sharply. When the egg is not fertilized, menstruation occurs. The level of the hormone in a woman’s blood is considered normal within the range of 4.9-49 ng/ml.

Carrying out regardless of the cycle

In special cases, research may be prescribed without taking into account the timing of the menstrual cycle. This is due to the urgent need to carry out analysis (on an emergency basis) and make the correct diagnosis, in accordance with the information received from the laboratory. In such a situation, the analysis is carried out within the next 1–3 hours. As a rule, with an emergency examination, the diagnosis is made on the same day, and treatment begins immediately.

Indications for which you need to donate blood for an emergency test:

suspicion of the presence of a hormone-producing pituitary tumor;

suspicion of the presence of a hormonally active ovarian tumor;

sudden appearance of severe pain in the area of ​​the mammary glands and genitals;

copious discharge of milk or colostrum from the mammary glands for no apparent physiological reason;

pronounced disruption during the ovulatory cycle;

severe menopause;

sudden cessation of milk production during lactation.

Before performing the analysis, it is prohibited:

undergo any other non-laboratory medical tests;

For 7-14 days, taking medications is prohibited. In some cases, only with a doctor’s prescription, you can stop using medications 3-4 days before the test;

use tobacco products 24 hours before the test;

have sex the day before the test. Sexual intercourse leads to an increase in prolactin concentration by 2-3 times;

experience negative or strong positive emotions;

expose the body to hypothermia or overheating (long hot baths, saunas, baths, visits to the beach, solarium, etc. are prohibited).

How to take the test correctly

After the doctor has ordered a test for lactotropin levels, you should properly prepare for the test. Before donating blood, it is advisable to get a good night's sleep and avoid stressful situations (they affect the level of lactotropic hormone). Blood is taken on an empty stomach (the last meal should be 12 hours before and consist of vegetables and/or fruits; fatty, meat foods, beans and dairy products affect prolactin levels) 3 hours after sleep, which is associated with a natural increase in lactotropin levels during night's rest. It is forbidden to consume food and drinks (even coffee or tea). The only exception is drinking pure still water. Such requirements are generally accepted.

Since blood for testing is taken from the ulnar vein, it is necessary to provide access to it. It is advisable to have sterile medical gloves and, depending on the method of collecting biological material, a syringe for intravenous injection (in most cases, only a needle is needed). It is better for pregnant women to come to a medical facility accompanied by relatives, as this reduces stress during the collection of biological material. The standard duration of a medical procedure is no more than 5-10 minutes. After blood sampling, the woman is recommended to rest for 10-15 minutes.

Standard research times take from 1 to 10 days, depending on the capacity and load on the laboratory of the medical institution. The results of the analysis are issued by the laboratory on a special sheet indicating the norm and actual concentration of lactotropin in the body. If a questionable result is received, the doctor must prescribe a repeat examination as soon as possible.

Attention! You can learn more about how to properly submit biological material for the purpose of analysis to determine prolactin concentration from your gynecologist or endocrinologist.

If you have your own point of view regarding the issue raised in the article, write to us. We value readers' opinions.

As a rule, tests for the level of hormones in the blood of women are taken on certain days of the menstrual cycle. Most often, studies are prescribed to determine the level of prolactin, LH and FSH in case of hormonal imbalances and the inability to conceive independently.

Prolactin is one of the main indicators, the level of which in the blood allows us to determine the general state of female hormonal status. Its main function is to ensure normal development of the mammary glands. The lactation process will depend on the level of prolactin in the blood.

In what cases is a prolactin test prescribed?

A blood test for prolactin levels is recommended in cases where:

• it is not possible to establish the cause of infertility;
• there are disruptions in the menstrual cycle;
• with mastopathy, there are complaints of frequent headaches and blurred vision;
• despite the absence of pregnancy, women begin to secrete colostrum from the mammary glands (galactorrhea);
• there is a sudden weight gain.

A reduced level of prolactin in the blood, as a rule, does not pose a direct threat to health. The concentration of the hormone may decrease while taking various medications, during postterm pregnancy, and in the case of undergoing radiotherapy. If tests for the level of other pituitary hormones do not show abnormalities, a low prolactin level does not require any additional treatment.

An increase in prolactin in the blood can directly affect fertility. Its increased content leads to disruption of the menstrual cycle. After childbirth, when a woman breastfeeds her baby, this hormone protects her from the early onset of another pregnancy. If the level of the hormone increases in a non-breastfeeding woman, it significantly reduces the production of progesterone and estrogen in the body, which reduces the likelihood of conception.

Also, elevated prolactin in the blood often indicates the presence of benign tumors of the pituitary gland or hypothalamus. Upon receipt of test results indicating an increased level of this hormone, additional tests are prescribed in the form of CT or MRI.

On what day of the menstrual cycle should you take the test?

Despite the fact that the amount of prolactin in women’s blood may vary depending on the menstrual cycle, the limits of the permissible norm of the hormone are the same for any menstrual phase. It is for this reason that it does not matter of fundamental importance on what day the woman will take the test. If the goal is to check the amount of prolactin after the end of breastfeeding, then it should be taken no earlier than 7 days after the last lactation.

What factors influence the level of prolactin in the blood?

In order to obtain correct research results, before donating blood, it is necessary to study factors that may affect the concentration of prolactin. The amount of this hormone can increase significantly under the influence of strong emotional experiences and stress. Intense physical activity can also cause an increase in prolactin levels in the blood. The same result can be achieved by taking thermal procedures the day before the test or a long massage of the cervical region (in this place there are nodes of the nervous system, stimulation of which can provoke increased production of prolactin by the pituitary gland).

How to take the test correctly

In order for the obtained research data to be correct, certain preparation is required for the analysis:

• Before donating blood, be sure to tell your doctor about any medications you are taking. The level of this hormone can increase in cases where a woman takes contraceptives, antihistamines, and antidepressants.
• The day before donating blood, it is necessary to avoid sexual intercourse, and also to avoid a state of sexual arousal.
• Before taking the test, you should not take a hot bath or visit the steam room.
• It is necessary to reduce physical activity as much as possible, refuse training and, if possible, limit lifting weights, avoid long climbs up stairs;
• You need to try to maintain emotional stability and not be stressed.

How to behave on the day of blood sampling

This test must be taken in the morning, on an empty stomach. Stop eating 8 hours before donating blood for testing. It is also prohibited to smoke an hour before the test. Before the actual blood draw, the woman is recommended to sit quietly in the laboratory waiting room for about 15-20 minutes so that she can rest and come to a state of complete calm.

Other tests to determine hormonal status in women

Along with prolactin, hormones that are produced by the anterior pituitary gland and tend to influence the functioning of the gonads and the state of the reproductive system include follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Conducting a study on their concentration in a woman’s blood can help in diagnosing problems with her hormonal levels.

The first indicator, follicle-stimulating hormone, which is known by the abbreviation FSH, promotes the growth of the egg within the follicle. It is given when it is necessary to monitor the effectiveness of hormone therapy. FSH is also prescribed when the following problems are observed:

• infertility and lack of ovulation;
• polycystic ovary syndrome;
• menstrual irregularities;
• very scanty periods;
• uterine bleeding;
• endometriosis.

Preparing for a study on FSH levels

In order to pass this test correctly and, accordingly, obtain correct data, a woman is recommended to undergo certain preparation. In the days preceding the test, it is advisable to avoid physical activity and avoid stressful situations. Smoking, fasting and circumstances such as:

• undergoing radiography;
• contact with lead;
• kidney disease;
• surgical intervention.

If at least one of these facts occurred a few days before the test, you need to warn your doctor about this.

Blood sampling to determine FSH levels is done 4-7 days after the start of the menstrual cycle. It is during these days of the first phase of the cycle that the maximum activity of the hormone is observed. When the results show low levels of the hormone, this may indicate hypofunction of the hypothalamus and pituitary gland. In cases where the indicator exceeds the norm, there are grounds to assume:

• ovarian depletion;
• polycystic disease;
• the presence of endometrioid cysts;
• pituitary tumor.

To determine the causes of infertility, it is very important to monitor the ratio of the amount of FSH to the level of luteinizing hormone, which is designated as LH.

Why undergo testing for LH levels?

This hormone is also produced by the pituitary gland and is responsible for the production of progesterone in the female body. Its concentration in the blood depends on the phase of the ovulation cycle. An LH test is prescribed when a woman has problems such as:

• increased hair growth;
• underdevelopment of the genital organs;
• lack of ovulation;
• infertility;
• polycystic ovary syndrome.

When the LH level result is below normal, there is often a parallel increase in the amount of prolactin in the blood. This condition is called hyperprolactinemia. An elevated LH level, as in the case of an elevated FSH level, may indicate the presence of a pituitary tumor, polycystic ovary syndrome, or serious kidney disease.

What day should you take the test?

The level of LH in the blood is correctly determined 4-7 days after the start of menstruation. If a woman's menstruation does not occur regularly, blood can be taken daily for 10 days. To reliably determine the LH indicator, the test is taken from 8 to 18 days before the expected start of menstruation.

Prolactin is actively secreted by the anterior pituitary gland under the control of the hypothalamus. The hormone stimulates the functional development of the mammary glands, causing lactation. In addition, it is assigned approximately 300 more biological functions, including the regulation of behavior, the immune system and maintaining the functioning of the corpus luteum in women.

The hormone is characterized by a pulsating nature of release: the concentration increases in the early morning and decreases in the evening. Since changes in its level often lead to serious consequences such as infertility, for an accurate result it is necessary to correctly take a prolactin test.

Indications

There are many indications for determining the level of this hormone in the blood. This study should be prescribed by the attending physician, as this will help avoid unnecessary tests and correctly interpret the results obtained. An analysis for the hormone prolactin is prescribed in the following cases:

• menstrual irregularities, which manifests itself in the form of amenorrhea and oligoamenorrhea;
• corpus luteum deficiency;
• anovulatory cycles;
• infertility;
• galactorrhea;
• polycystic ovary syndrome;
• use of drugs that cause hyperprolactinemia;
• the appearance of secondary male sexual characteristics in women (virilism);
• detection of tumors of the pituitary gland or mammary gland;
• symptoms of increased intracranial pressure;
• visual field impairment;
• osteoporosis;
• dyshormonal processes of the mammary gland;
• premenstrual syndrome;
• decreased libido (hyperprolactinemia reduces testosterone in the blood in men);
• lack of milk production after childbirth;
• diagnosis and monitoring of therapy for prolactin-secreting neoplasms.

When hyperprolactinemia occurs, follicle-stimulating (FSH) and luteinizing (LH) hormones decrease. This effect explains the fact that during lactation a woman practically cannot become pregnant. Progesterone, which is produced by the corpus luteum of the ovaries, also decreases, which leads to various changes in menstruation and even the inability to conceive and carry a child.

May be caused by true hyperprolactinemia, in which the level of prolactin monomers increases. If the result is more than 700 mlU/L, you additionally need to take a macroprolactin test. It is not biologically active, and consists of dimers and polymers of the hormone.

Selecting a day for analysis

On what day should I take this hormone? Before taking a prolactin test, you should consult your doctor. In general, its concentration varies little depending on the days of the menstrual cycle, but the level in the second phase (luteal) is slightly higher than in the first (follicular).

The period when you can take a prolactin test is not limited to the days of the menstrual cycle and you can donate blood for testing at any convenient time, following all the necessary preparation rules.

Since this hormone has a cyclical type of secretion, you need to take a prolactin test early in the morning, from 8 to 11 o’clock, no later than 3 hours after sleep.

To clarify the diagnosis, tests of other sex hormones may sometimes be required. In clinical practice, a combination of tests is often used: sex hormone binding globulin (SHBG), FSH, LH, progesterone, . And these additional tests must be taken on certain days of the cycle to avoid false results.

Preparation

Despite the fact that this sexual hubbub can be taken on any day of the cycle, there are many requirements to obtain an accurate result. Preparation for the test includes avoiding excessive physical and emotional stress, as well as sexual intercourse one day before the planned examination. You should avoid thermal procedures (sauna, hot bath), stimulation of the mammary glands and nipples. For this reason, breast examination before the test should be avoided.

The concentration of which can increase with increased stress, mental trauma, exposure to adverse weather conditions, sudden changes in time zones, etc.

Taking certain medications, such as antihistamines, antipsychotics, oral contraceptives, antidepressants, verapamil, metoclopramide, bromocriptine, etc., may cause changes in the concentration of the hormone. Therefore, a prolactin blood test should be taken after stopping these drugs. Occasionally, blood testing for prolactin may be necessary to monitor dosage during therapy with these medications.

The day before the test, you should give up protein foods and alcoholic drinks, and it is optimal to take an easily digestible vegetable dinner. A blood test for prolactin should be taken 10-14 hours after the last meal. You need to go to bed early enough so that your sleep duration is at least 7–8 hours.

On the day of the study

On the chosen day, you need to take prolactin in the morning. If the time for donating the hormone was missed, it is better to refuse to visit the laboratory on that day.

It is necessary to take prolactin correctly on an empty stomach, avoid drinking tea and coffee. If necessary, you can drink a few sips of clean water. Upon arrival at the laboratory, the patient should rest and relax for at least 15 minutes.

It is very important not to smoke, as nicotine can trigger the release of hormonal substances. Also, you should not wear very tight or uncomfortable underwear, so as not to further stimulate your breasts.

The laboratory must be informed of the day of the menstrual cycle. This will help you choose the standard of analysis that corresponds to the hormonal period of a girl or woman.

Prolactin test for pregnant women

To test for prolactin, blood is taken from pregnant women early in the morning. A woman must be sure to report her situation and the timing. This is done because the prolactin level in pregnant women is much higher.

Failure to comply with the rules for taking the test and imperfect technical methods for detecting this hormone are the main obstacles to obtaining correct research results. Only a qualified gynecologist or endocrinologist should interpret the results and prescribe treatment.

Very often, when taking tests for sex hormones, women have a question: what is prolactin and on what day of the cycle should it be taken?

Prolactin is of great importance for women's health.

Its concentration affects the reproductive capabilities of the body, as well as the proper functioning of the mammary glands during the lactation period.

The hormone that is produced in the adenohypophysis by lactotropic cells is called prolactin, lactogenic hormone or mammotropin.

In the female body it plays a more significant role than in the male body and is therefore produced in greater quantities. But it is involved not only in the sexual functions of the body. His trace is seen in the work of the following bodies:

• hearts;
• lungs;
• thymus;
• liver tissue;
• spleen;
• muscle and nervous tissue;
• urinary system.

Prolactin even affects the skin. Due to the fact that this hormone affects the functioning of almost the entire body, it is called multilateral. But in many ways its mechanism of action on the human body is completely not studied.

Where is mammotropin formed?

Despite the fact that prolactin is formed in the pituitary gland, its synthesis is influenced by the following glands and organs:

• mammary gland;
• placental tissue;
• CNS cells;
• cells of the immune system;
• hypothalamus.

The secretion of prolactin is influenced by hormones such as dopamine and estrogen. Violation of the synthesis of these hormones entails a change in the amount of prolactin produced.

Functions of luteotropic hormone

The most prominent role of prolactin is reproductive activity, as well as providing the newborn with the necessary nutrition. First of all, the lactogenic hormone influences the following processes in the female body:

• on the rhythm of the cycle;
• for egg maturation;
• for breast growth;
• on the formation of the placenta;
• on endometrial growth;
• for lactation.

The occurrence of malfunctions of the pituitary gland entails a disorder of the sexual function of the body and can affect the occurrence of infertility.

Why do they give prolactin?

May prescribe a prolactin test in the following cases:

1. without confirmation of pregnancy or menopause.
2. Irregular rhythm of the cycle.
3. Periodic bleeding on days not associated with menstruation.
4. Pain in the mammary glands.
5. The appearance of colostrum in a non-pregnant woman.
6. Infertility.
7. Decreased vision.

This list may also include cosmetic problems such as excess weight and acne. Based on the patient’s complaints, the doctor prescribes hormonal screening, which also includes a prolactin test.

Features of the analysis for mammotropin

If the screening shows a result different from the norm, the doctor will additionally prescribe the following laboratory tests:

• dimer assay;
• macroprolactin test;
• monoprolactin screening.

Macroprolactin- This is an inactive form of the hormone and has the largest peptide size.

Therefore, it does not lead to any serious complications. Based on the results of a comprehensive analysis, further actions in diagnosis and treatment are determined.

Excess of mammotropin

A prolactin test may show an elevated result. This can mean a number of diseases:

• prolactinoma;
• hyperfunction of the thyroid gland;
• PCOS;
• adenoma in the brain;
• liver damage by cirrhosis.

If hyperprolactinemia is left untreated, signs of bone tissue destruction may begin, which will require enhanced treatment measures.

The reasons for this condition may be the following factors:

• excessive stress, psychosis;
• abuse of psychotropic drugs;
• use of COCs (oral contraceptives);
• alcoholism;
• addiction.

Traumatic brain injuries can lead to the appearance of benign formations in the head, which will also affect the state of the endocrine system.

What to do if prolactin is elevated?

To confirm hyperprolactinemia, an analysis is performed three times. If all the results show an increase in the concentration of the hormone in the blood, then a more thorough diagnosis is performed, which includes the following manipulations:

• study of thyroid function;
• radiological examination of the cranium;
• conducting a thorough examination by an ophthalmologist;

To begin proper treatment of this pathology, it is necessary to accurately diagnose. The first signal for an in-depth examination will be a test for the hormone prolactin.

For physiological reasons for the increase in lactogenic hormone, therapy will consist of eliminating the provoking factor. And if the causes are pathological, then medical intervention is necessary, which will consist of the following treatment methods:

• medicinal;
• surgical;
• radioactive.

After therapy, you should monitor your health and periodically check the level of the lactotropic substance.

Lack of mammotropin

Insufficient function of pituitary lactocytes may be due to the following factors:

• taking certain medications;
• pituitary adenoma;
• tuberculosis;

By taking a prolactin test, you can detect its deficiency. It is treated by eliminating the underlying cause of the disorder or stopping or changing the drug that is causing the disorder.

In pregnant and nursing mothers

During pregnancy, the concentration of mammotropin in the blood increases and does not fall after childbirth. In this case, milk begins to be released only during lactation. This is due to the following processes in the mother’s body:

1. Progesterone, which is involved in the growth of the placenta is decreasing and thus ceases to restrain the secretion of milk.
2. The sucking mechanism is based on irritation special receptors that transmit signals to the brain.
3. Happening decline, which also inhibits the increase in the amount of prolactin in the blood.
4. Important for the functioning of the mammary glands elevated, which is produced in the posterior lobe of the pineal gland.

If a newborn produces colostrum from the papillae, this may be a sign of increased prolactin during pregnancy. This symptom disappears soon after birth.

Prolactin norms

The concentration of prolactin in the blood serum depends on the following conditions:

• from the floor;
• from age;
• depending on the phase of the cycle in women.

For childbearing age analysis for prolactin, its concentration is considered to be within 4.6 - 24 ng/ml. Moreover, at the time of ovulation and in the luteal phase, the result will be higher: from 5 to 33 ng/ml.

Pregnant women have an increased level of prolactin in the blood - this is a physiological norm. The amount of hormone will vary from 32 to 380 ng/ml.

The indicators for men are slightly lower: 3 - 16 ng/ml.

Each laboratory, when ordering a test, always issues a memo that indicates all hormonal norms. Therefore, you can easily determine your hormonal status using these tips.

On what day of the cycle should I take it?

Many people ask the question: “On what day of the cycle should I take prolactin?” The answer is extremely simple: a non-pregnant woman’s blood is taken for prolactin in the first 3 days of the cycle during menstruation. The following hormones are also tested on this day:

• estradiol;
• progesterone.

It is known that if a patient has problems with her cycle and her menstruation does not occur for several months, then such women can take hormones any day.

Taking COCs may affect the accuracy of hormonal test results. Therefore, it is recommended to stop using synthetic hormones before screening.

Preparing for a prolactin test

Like any type of examination, analysis requires preparation. The following rules must be adhered to:

1. Refusal of sexual intercourse for 2-3 days before the analysis.
2. Be calm.
3. Maintain physical rest, do not overwork.
4. Don't go to the steam room.
5. Avoid large amounts of glucose in your diet.
6. Do not smoke or drink alcohol.

If there is such an opportunity, then immediately before taking the biomaterial you can lie down or sit for a few minutes so that the pulse returns to normal.

How to behave before taking the test?

Directly on the day when you need to take the test, you need to do the following:

1. Wake up with the expectation that blood sampling will take place no less than 2 hours after waking up.
2. Do not eat anything before the screening.
3. You can drink some plain water without additives.

Be sure to take something with you sweet, what you can eat after the analysis. Blood is donated from a vein under completely sterile conditions.

If the test is performed correctly, you will get an accurate result that will reflect the true picture of the patient’s well-being.

If a woman experiences any symptoms associated with a cycle disorder, she should not delay testing her pituitary and thyroid hormones. Accurate test results will ensure timely diagnosis and preservation of women's health with the help of competent therapy.

Prolactin(luteotropin, mammotropin) is a pituitary hormone that is responsible for the growth of the mammary glands and ensures the production of breast milk in women. It is found in small quantities in the body of men.

A distinctive feature of prolactin is sharp fluctuations, which may be associated with sleep, medication, active sexual stimulation, or chest trauma. In healthy people, hormone levels return to normal within a few hours. Long-term increases in prolactin levels in the blood require adjustment as they can cause health problems.

Hyperprolactinemia– high levels of prolactin in the blood, occurs in 1% of women. Increased production of the hormone outside of pregnancy and lactation can have serious consequences, including cessation of menstruation and infertility. An increase in prolactin in men is extremely rare.
To determine the level of prolactin, you need to donate blood from a vein.

The role of prolactin in the body

Prolactin produced by the anterior lobe of the pituitary gland. Its synthesis is regulated by another hormone - dopamine, which is secreted by the nuclei of the hypothalamus. Entering the pituitary gland through the bloodstream, it blocks the release of prolactin. Progesterone, produced by the corpus luteum of the ovaries in the second half of the menstrual cycle, also reduces the secretion of prolactin.

Daily rhythm of secretion

The highest level of the hormone is observed in the deep sleep phase and immediately after waking up, then its concentration decreases. In this regard, it is recommended to take the test approximately 3 hours after waking up.

How does prolactin work?

Breast cells have receptors that bind to prolactin molecules. The result of this interaction is active cell division, due to which the growth of lobules and ducts of the mammary glands occurs, as well as milk production. The same receptors are found in the cells of other organs, but the effect of prolactin on them has not been fully established.

Forms of prolactin

There are several forms of prolactin in the human body.

Monomeric– the most active, it causes corresponding changes in the body.
Dimeric form of prolactin does not bind to cell receptors.
Polymer the form does not pass through the capillary wall due to the large size of the molecule and has no effect on the body. In the presence of a polymeric and dimeric form, a prolactin test shows an excess of the norm, but symptoms of hyperprolactinemia do not occur and treatment is not required.

Functions of prolactin in the body
Women	Men
Development of the mammary glands during puberty. Growth of the mammary glands due to enlargement of the lobules and ducts. Production of colostrum and milk Regulation of estrogen production. Regulation of the phase of the corpus luteum and the menstrual cycle. Preventing pregnancy during lactation. Formation of attachment to a child. Normalization of metabolism. Strengthening bone tissue, enriching it with calcium.	Regulation of water-salt balance. Normalization of metabolism. Maintaining normal testosterone levels. Normal sperm maturation, increased motility. Growth of seminal vesicles and prostate. Increased muscle mass. Strengthens bones, improves calcium absorption.

Prolactin release during pregnancy and after childbirth

During pregnancy, prolactin levels increase 20-fold, which is caused by high levels of estrogen and progesterone. High doses of prolactin provoke breast enlargement and darkening of the areola in pregnant women. In this case, estrogen and progesterone block the production of breast milk, despite high progesterone levels. Immediately after birth, the concentration of estrogen and progesterone drops and colostrum and then milk begin to be released.

Prolactin stabilizes 4-6 weeks after birth. But its level remains consistently high for several more months due to stimulation of the nipples during feeding, which allows maintaining lactation. This mechanism explains the fact that frequent breastfeeding increases milk supply.
A high level of prolactin in a nursing mother protects her from re-pregnancy. It suppresses the formation of gonadotropic hormones of the pituitary gland and prevents ovulation and the development of the corpus luteum, which is manifested by the absence of menstruation in the first months of breastfeeding. Occasionally, pregnancy can still occur under such conditions.

Why is a prolactin test prescribed? (main indications for this analysis)

Indications for prolactin testing
Women	Men
Breast pathologies. Galactorrhea is the secretion of milk not associated with breastfeeding. Amenorrhea is the absence of menstruation. Signs of hyperandrogenism (excess male sex hormones) – acne, excess body hair. Infertility. Miscarriage - miscarriages, premature births. Hypothyroidism is a disease associated with low levels of thyroid hormones. Suspicion of a pituitary tumor Neoplasms in the ovaries - cysts, tumors.	Gynecomastia is enlargement of the mammary glands. Infertility. Lack of sperm in the ejaculate. Suspicion of a pituitary tumor.

Signs of elevated prolactin levels at different ages

The main signs of increased prolactin in women– this is discharge from the nipples and delayed menstruation. The symptoms of elevated prolactin are closely related to its ability to block the action of female sex hormones - estrogen and progesterone. In men, on the contrary, prolactin enhances the effect of estrogen, but blocks testosterone.

Girls	Boys
Late periods or their absence is primary amenorrhea. Menstrual irregularities. Underdevelopment of the external genitalia and mammary glands. Discharge of fluid from the nipples.	Delayed puberty. Enlargement of the mammary glands. Characteristic body proportions: long arms and legs, high waist, hips wider than shoulders, fat deposits in the nipples, lower abdomen and lower back. Weak muscles. High voice. Testicles (testicles) are reduced. There is no sexual desire and interest in sex.

Long-term exposure to high doses of prolactin in adults causes disturbances in the functioning of various organs and systems.

Signs of increased prolactin
Women	Men
Discharge from the mammary glands. The fluid released may be clear or resemble breast milk. The amount varies from a few drops when pressed to several milliliters and spontaneous discharge. Enlargement of the mammary glands due to the growth of the epithelium of the lobules and ducts. Mastopathy - compactions in the mammary glands, the formation of cysts and adenomas. Menstrual dysfunction: irregular menstruation, heavy and painful bleeding. Amenorrhea is the cessation of menstruation for 6 months or more. Infertility. High levels of prolactin block ovarian hormones, disrupting egg maturation and ovulation. This makes pregnancy impossible. Miscarriage. Frigidity is a lack of desire to have sex. Polycystic ovary syndrome. High prolactin disrupts the ovulation process, as a result, numerous cysts form in place of mature follicles. Increased body weight associated with water retention and increased fat deposits. Acne on the face and upper body. Frequent bone fractures and multiple caries due to leaching of calcium salts. Impaired peripheral vision, double vision due to compression of the optic nerves by the pituitary adenoma. Emotional stability and sleep disturbances.	Decreased sexual desire and impaired potency, which is caused by a decrease in testosterone. Gynecomastia is the growth of the mammary glands. Obesity. Frequent fractures and multiple caries. Visual impairment due to large pituitary adenomas compressing the optic nerves. Decreased vitality, chronic fatigue.

Signs of low prolactin levels

A decrease in prolactin is a rather rare phenomenon. It may be associated with damage to the anterior lobe of the pituitary gland of various natures or with increased sensitivity of the body to dopamine, which interferes with the production of prolactin.

Symptoms of low prolactin levels
Women	Men
Infertility. Menstrual irregularities. Miscarriages in early pregnancy. Lack of milk during the lactation period. Migraine attacks. Depressed state, obsessive fears. Hypertensive crises. Increased hair growth on the face and back.	Deterioration in sperm quality, decreased sperm motility. Decreased potency. Prostatitis. Emotional instability, anxiety.

How to prepare for a prolactin test

To obtain the most accurate test results, you must stop taking medications that affect prolactin synthesis at least 3 days in advance. Their list is presented in the following sections of the article. If it is not possible to discontinue the medications, then it is necessary to inform the laboratory staff about the medications being taken and their dosage.

The day before the study, if possible, refrain from:

• injuries;
• smoking;
• alcohol;
• psychotropic substances;
• abundance of protein and carbohydrate foods;
• sexual intercourse;
• irritation of the nipples and areolas - sexual stimulation, tight underwear;
• thermal procedures - baths, hot baths;
• lack of sleep;
• physical activity.

If these factors cannot be avoided, it is recommended to postpone the test for 3 days.
On the morning of the test, you must avoid food, tea and coffee.
Blood testing for prolactin must be done in the morning: from 9 to 11.

On what day of the menstrual cycle is blood taken for analysis?

The level of prolactin in the blood does not depend on the day of the menstrual cycle. Therefore, you can take a prolactin test any day.

However, some endocrinologists indicate that the best period for taking a prolactin test is days 5-8 of the menstrual cycle.

Normal prolactin values

Categories	Normal values ​​ng/ml
Women
Non-pregnant over 17 years of age	4,79-23,3
Pregnancy 1st trimester	23,5-94,0
Pregnancy II trimester	94,0-282,0
Pregnancy III trimester	188,0-470,0.
Men
Over 17 years old	4,04-15,2

It must be taken into account that the level of prolactin is not stable and significant physiological fluctuations are possible in a healthy person. If the prolactin level is increased by 1.5-2 times, but there are no symptoms, then it is recommended to retake the test after 10-14 days.

In what pathologies are prolactin levels elevated?

Situations in which prolactin may increase in healthy people (physiological hyperprolactinemia):

• pregnancy;
• breastfeeding period;
• infants from birth to 3 months;
• chest injury;
• abortion;
• previous surgical operations on the chest;
• sexual contact, intense nipple stimulation;
• stress;
• hypoglycemia – low blood sugar;
• high protein diet;
• overheating, visiting a sauna, bathhouse;
• heavy physical training;
• injuries;
• pain;
• hypovitaminosis of vitamin B6 (pyridoxine);
• taking medications:

• hormonal drugs containing estrogen and contraceptives;
• dopamine blockers – sulpiride, domperidone;
• neuroleptics – haloperidol, sulpiride, perphenazine;
• antiemetics – cerucal, chlorpromazine, aeron;
• tricyclic antidepressants – haloperidol, imipramine, amitriptyline;
• antihypertensive drugs – reserpine, verapamil;
• cocaine, opiates, promedol.

In what pathologies are prolactin levels reduced?

• Pituitary apoplexy(Sheehan syndrome) is an acute circulatory disorder leading to necrosis in the pituitary adenoma.
• Massive blood loss over 500 ml, for example, bleeding after childbirth.
• Brain tumors leading to compression of the pituitary gland.
• Pituitary tuberculosis– a rare form of tuberculosis.
• Radiation therapy, which caused the destruction of pituitary cells;
• Traumatic brain injuries accompanied by swelling or damage to the pituitary gland.

Situations in which prolactin decreases in healthy people:

• post-term pregnancy beyond 41 weeks;
• smoking and alcoholism;
• starvation;
• age over 50 years;
• long-term use of medications:

• antiepileptics - valproic acid, phenytoin, carbamazepine;
• dopaminergic drugs - levodopa, bromocriptine, dopamine;
• hormonal drugs - terguride, dexamethasone, nafarelin, danazol, cyproterone, epostane, calcitonin, tamoxifen, mifepristone;
• anti-tuberculosis - rifampicin;
• antihypertensive – nifedipine;
• opioids - morphine.

How to reduce prolactin levels in a woman?

Before starting treatment for elevated prolactin, it is necessary to establish the cause of hyperprolactinemia. Medical examination consists of several stages.

1. Computed tomography CT, magnetic resonance imaging MRI or x-ray of the skull in 2 projections to exclude a pituitary tumor.
2. Study of thyroid function to exclude hypothyroidism - ultrasound.
3. Pregnancy test for women of reproductive age. If there is a possibility that the woman does not know that she is pregnant.
4. Biochemical blood test to determine the condition of the liver and kidneys.
5. Hormone tests to exclude diseases of the endocrine system accompanied by an increase in prolactin:

• TSH is thyroid stimulating hormone of the thyroid gland.
• IGF-1 is insulin-like growth factor 1, which regulates somatotropin secretion.
• FSH is follicle-stimulating hormone of the anterior pituitary gland.
• Determination of the level of macroprolactin (inactive forms) by polyethylene glycol precipitation.

Treatment of hyperprolactinemia depends on the reasons that caused the increase in prolactin

1. Treatment of diseases of the endocrine system leads to normalization of hormonal status and a decrease in prolactin. Sometimes medications have to be taken for life. Depending on the detected pathology, the following is prescribed:

• analogues of the thyroid hormone thyroxine (euthyrox, L-thyroxine);
• adrenal hormones (hydrocortisone, prednisolone, fludrocortisone);
• Estrogen antagonists (tamoxifen) increase the sensitivity of estrogen receptors.

Indications: hypothyroidism, polycystic ovary syndrome and adrenal insufficiency.
Contraindications: individual intolerance to the components of the drug, myocardial infarction, myocarditis.
Efficiency. With properly selected hormonal therapy, the effectiveness of treatment is high.

1. Suppression of prolactin synthesis. Dopamine D2 receptor agonists are used. Parlodel 2.5-3.5 mg per day, lisuride 0.05-0.075 mg, Dostinex 0.5 mg once a week. These drugs bind to dopamine receptors in the brain, causing the pituitary gland to release fewer prolactin molecules. The hormonal activity of the tumor and its size are reduced, lactation is suppressed and the menstrual cycle is normalized. The dosage and duration of administration are determined individually, based on test results.

Indications: prolactinomas, micro- and macroadenomas of the pituitary gland.
Contraindications: hypersensitivity to the components of the drug, hypertension, myocardial infarction, myocarditis, benign tumors of the mammary glands.
Efficiency high. In most patients, it avoids surgery to remove a pituitary tumor.

1. Radiation therapy. Destruction of a pituitary tumor by ionizing radiation. It is combined with drug therapy or performed after surgical treatment.

Indications: large pituitary tumors that are not amenable to drug therapy.
Contraindications lymphopenia, leukopenia, thrombocytopenia, anemia, diseases of the nervous system, diseases accompanied by fever, purulent or inflammatory processes in the area of ​​irradiation, diseases of the cardiovascular and respiratory systems, renal failure.
Efficiency

1. Surgery. Removal of a pituitary tumor is carried out through the nasal sinuses.

Indications: visual impairment, ineffectiveness of drug treatment.
Contraindications. Pregnancy, childhood and old age, inflammatory diseases (sinusitis, sinusitis, tonsillitis), acute diseases and exacerbation of chronic diseases.
Efficiency high for microadenoma, tumor less than 10 mm. With large adenomas, the probability of tumor reappearance is 20-40%.
Asymptomatic macroprolactinemia in women does not require specific treatment. If the amount of inactive forms of prolactin in the blood is increased, which do not bind to cell receptors, then there are no symptoms - a regular menstrual cycle, no discharge from the nipples. In this case, the analysis shows that prolactin levels are exceeded. With macroprolactinemia, there is no need to reduce prolactin levels.

How to reduce prolactin levels in a man?

An examination algorithm to determine the cause of increased prolactin in men.

1. X-ray of the skull in 2 projections, CT or MRI to detect a tumor in the pituitary gland.
2. Ultrasound of the thyroid gland for the diagnosis of hypothyroidism.
3. Biochemical blood test to detect signs of liver and kidney disease.
4. Hormone tests to identify diseases of the endocrine system:

• TSH – thyroid-stimulating hormone of the thyroid gland
• IGF-1 is an insulin-like growth factor 1 that regulates the secretion of somatotropin.
• LH is the luteinizing hormone of the anterior pituitary gland.
• FSH – follicle stimulating

Treatment is prescribed based on the patient's examination results.
Indications: prolactinomas, pituitary adenomas, brain injuries and other pathologies that provoke an increase in prolactin.
Contraindications: individual intolerance to drugs, hypertension, myocardial infarction, myocarditis, benign tumors of the mammary glands.
Efficiency high. In most patients, it avoids surgery.

1. Hormone replacement therapy. For hypothyroidism, synthetic thyroid hormone (euthyrox, L-thyroxine) is prescribed. If adrenal function is impaired, analogues of their hormones (hydrocortisone, prednisolone, fludrocortisone) are taken. Restoring hormonal balance leads to normalization of prolactin.

Indications: hypothyroidism, conditions after thyroid surgery and adrenal insufficiency.
Contraindications: individual intolerance to the components of the drug, myocardial infarction, myocarditis.
Efficiency high with proper selection of the dose of the drug. Lifelong medication may be required.

1. Radiation therapy. Exposure of a pituitary tumor to ionizing radiation. Combined with drug therapy or after surgical removal of the tumor. Perhaps remote irradiation or the introduction of isotopes into tumor tissue.

Indications: pituitary tumors 1-3 cm, not amenable to drug therapy.
Contraindications the distance to the optic nerves is less than 5 mm, increased levels of lymphocytes, leukocytes, platelets, diseases of the nervous system, increased temperature, purulent or inflammatory foci in the area of ​​irradiation, diseases of the respiratory system, renal and heart failure.
Efficiency high, in combination with other treatment methods.

1. Surgery. Removal of a pituitary tumor through the sinuses using an endoscopic surgical instrument. Macroadenomas larger than 2 cm are removed by craniotomy.

Indications: visual impairment, ineffectiveness of drug treatment, hemorrhage into the tumor.
Contraindications. Senile age, foci of inflammation in the head area (sinusitis, sinusitis, tonsillitis), acute diseases and exacerbation of chronic diseases, uncompensated heart defects and renal failure.
Efficiency high for microadenoma, tumor less than 10 mm. For large adenomas over 2 cm, the probability of tumor reappearance is 15%.