And whether you know...
Giperprolaktinemiya is a certain condition of an organism at which too intensive producing prolactin is shown. Respectively, its level in blood considerably increases. This disease is more often shown at women, however it occurs and at men. Most often the giperprolaktinemiya is diagnosed for women whose age makes from 25 to 40 years.
Formation of prolactin
Prolactin, as well as some other hormones, in a human body is formed in a hypophysis. It is also accepted to call it "milk" hormone as prolactin stimulates emergence of milk in the woman who gave birth to the kid. At the same time at males this hormone is produced in much smaller quantities.
In a closed gland of a hypophysis except prolactin it is produced also luteinizing (LG) and follicle-stimulating (FSG) hormones. All these hormones are responsible for regulation of approach of an ovulation and periods. Besides, they stimulate a producing estrogen, and also maturing of an ovum in a female organism. In a man's organism these hormones are responsible for production of testosterone, male sex hormone and regulate the level of mobility of spermatozoa. Respectively, at patients with a giperprolaktinemiya concentration of prolactin sharply increases in blood.
Prolactin stimulates production of colostrum at the beginning of feeding with a breast, and promotes its transformation into mature milk later. Prolactin also directly influences growth of mammary glands, and also increase in quantity of canals and segments. Effect of this hormone on a female organism is shown by extension of existence of a yellow body of ovaries and braking of process of an ovulation. Therefore, there is a braking of process of new conception. If this mechanism remains normal, then prolactin promotes prevention of pregnancy and lack of periods during breastfeeding. However patholologically the increased content of prolactin in an organism of the woman is fraught with manifestation of frigidity, an anorgazmiya and infertility.
Except the functions described above prolactin is responsible for regulation of a water salt metabolism in an organism the person: kidneys under its influence remove water and salt more slowly.
Specialists allocate many different reasons, as a result of leading to development of a giperprolaktinemiya. It is accepted to distinguish physiological and pathological forms of a disease. At healthy women increase of level of prolactin in an organism happens under the influence of some physiological factors. For example, the content of prolactin can increase in the period of a dream, in the course of breastfeeding, owing to a severe stress or serious exercise stresses, during sexual contact, at pregnancy and during the period after the child's birth.
The pathological giperprolaktinemiya is subdivided, in turn, on organic and functional. Development of an organic form of an illness happens owing to emergence of tumors of a hypophysis – so-called microprolactin and macroprolactin. Such tumors are high-quality, however they strenuously make prolactin. They, as a rule, increase very slowly, and sometimes can not grow in general. But till today it is definitely not known what factors directly influence emergence of such educations. The size prolactin can be a miscellaneous, but nevertheless educations which diameter does not exceed 10 mm most often are found. In this case it is about a mikroprolaktinoma. In more exceptional cases doctors find hypophysis tumors which have diameter more than 10 mm. Such educations call makroprolaktinomam. Manifestations of a functional giperprolaktinemiya are connected with the most different diseases. So, this pathology can be shown at hyper triose — insufficiency of function of a thyroid gland; at a chronic renal failure, a syndrome of polycystic ovaries, cirrhosis, and also at some other diseases. If the woman underwent operations or injuries in a thorax, reusable a scraping of a cavity of the uterus, then development of a giperprolaktinemiya is also probable further. Rather often functional giperprolaktinemiya is shown at women who suffer from different diseases of gynecologic character. So, women with endometriosis, a hysteromyoma, development of inflammatory processes are subject to this form of this illness.
Also some medicamentous drugs which are appointed in high doses can influence increase of level of prolactin. Similar influence is characteristic of antidepressants, neuroleptics, drugs with hypotensive effect, estrogen, prostaglandins, oral contraceptives.
However one more form of a disease – a so-called idiopathic giperprolaktinemiya is allocated. At the same time at the patient the increased prolactin level in an organism, but the reasons causing such pathology no takes place. In this case excess of prolactin appears owing to too high function of cells of a hypophysis. However their quantity at the same time remains normal or increases very little.
If at the patient prolactin level in blood increases, then similar pathology can have different signs. If at the woman the giperprolaktinemiya develops, symptoms of this state are shown by a periods delay, its total absence or insufficiency of the second phase of a monthly cycle. The ovulation cycle can be broken, at the same time periodically from mammary glands colostrum or milk is emitted. In view of so serious violations of a menstrual cycle female infertility can become a result of a giperprolaktinemiya. Except the described manifestations, at a giperprolaktinemiya at women increase in the sizes of mammary glands, and also development of adenomas or cysts of mammary glands is sometimes observed. Over time the given high-quality educations can regenerate in breast cancer.
At the same time the increased amount of prolactin in an organism of the man influences formation of testosterone: its content in blood decreases. Lowering of a libido, that is interest in sexual life becomes a result of such phenomenon. Owing to progressing of a disease at men oppression of maturing of spermatozoa in testicles is observed, manifestation of a gynecomastia (increase in mammary glands), and also a galactorrhoea is sometimes possible (colostrum follows from nipples). Later at the man impotence, and also infertility can develop.
Therefore, symptoms of a giperprolaktinemiya have to become a reason for the immediate address to the specialist for representatives of both floors.
Diagnosis of a giperprolaktinema
The most important method in the course of inspection of patients with suspicion on a giperprolaktinemiya is hormonal inspection at which perhaps exact determination of content of prolactin in blood. At the woman make blood sampling from a vein for carrying out such research, and it is necessary to do it in the morning, during the period between the 5th and 8th days of a menstrual cycle. Before carrying out the analysis it is impossible to have sexual contacts for one days, to take alcoholic drinks, to visit a sauna. It is important to avoid stressful situations and impact on mammary glands. If at the first research the increased content of prolactin in blood was revealed, then it is necessary to conduct repeated hormonal researches later, and, them there have to be not less than three. The matter is that the increase of prolactin found once can be temporary and not confirm development in an organism of the woman of a certain illness.
In the course of diagnosis of an organic giperprolaktinemiya examination of area of a hypophysis is conducted. The kraniografiya method — carrying out a x-ray film of a skull in two projections is for this purpose used. Besides, informative and exact methods of inspection in this case are the computer tomography and a magnetic and resonant tomography.
Treatment of a giperprolaktinemiya
Now treatment of a giperprolaktinemiya is carried out with use of some medicamentous means. Most often for prolactin normalization sick appoint drugs Bromocriptinum, norprolak, kabergolin (dostineks). Owing to influence of these drugs several weeks later after an initiation of treatment the producing a tumor of prolactin decreases to normal indicators. If the content of prolactin in blood is normalized, then women note also recovery of a menstrual cycle. Respectively, there is a recovery of ability of the woman to conceive the child. At the same time pregnancy after reduction in norm of level of prolactin can come already at the following cycle. Therefore those women who do not platinize soon to give birth to the kid, have to pick up carefully the contraception method which is most suitable for them.
After treated at men occurs recovery of normal level of testosterone. As a result, the sexual inclination renews, and sex life of the man is normalized.
At treatment by drug Parlodelum occurs also gradual reduction of the size prolactin. The course of treatment Parlodelum in certain cases comes to the end with reduction of microadenoma, its necrosis and a total disappearance.
At patients from makroprolaktinoma similar treatment has to be followed by periodic tomographic research that in dynamics to estimate change of the sizes of a prolaktinoma.
In view of the proved efficiency of treatment by means of medicamentous means existence at patients with prolactin very seldom is the indication to carrying out surgeries and radiation therapy. Such interventions are reasonable only in some separate cases if makroprolaktinoma do not decrease in sizes in the course of carrying out treatment by medicamentous means.
The woman has to realize that at the timely address to the doctor and carrying out the correct course of therapy the forecast at a giperprolaktinemiya quite favorable. At the same time the recovered patient will be able to have further children.
Giperprolaktinemiya and pregnancy
Ensuring normal functioning of reproductive system of the person happens to direct participation of hormone prolactin. Therefore the increased level of this hormone stimulates manifestation of one of the most often found forms of hormonal female infertility. Giperprolaktinemiya and pregnancy is a signal for the doctor that the woman has to stay constantly under careful control. It is especially important to visit the oculist and the neuropathologist regularly. At the same time the woman, as a rule, continues to accept drug Parlodelum. If the patient accepted this drug also before pregnancy for a year or more long time, then the risk of further development or recurrence of a prolaktinoma considerably decreases. Therapy with use of this drug during incubation of the child is safe both for mother, and for the kid.
At the normal course of pregnancy at the healthy woman the content of prolactin increases in an organism from 8 to 25 week. Just before childbirth the level of prolactin decreases, and during feeding by a breast increases again.
Prevention of a giperprolaktinemiya
If the woman already had a giperprolaktinemiya, then it should pass dispensary observation not to allow a palindromia. For this purpose at least once a year the computer tomography is carried out and determination of level of prolactin in blood is twice a year made.
As for prevention of a giperprolaktinemiya, about effective methods the speech cannot go as etiologies very versatile. However the woman at reception of the combined oral contraceptives throughout a long time should determine the content in prolactin blood surely.