What is prolactin and what is it responsible for?

Prolactin (a.k.a. 'milk hormone' or luteotropic hormone - LTH) is a hormone produced mainly in the pituitary gland, so named because of the role it plays in lactation. Cells in the pituitary gland produce prolactin, where it is stored and then released into the bloodstream.

Human prolactin is also produced in:

uterus,
immune cells,
brain, breast,
prostate,
skin,
adipose tissue,

However, in much smaller quantities. This hormone has a variety of functions in the body, from acting on the reproductive system to regulating the immune system. In addition, it affects metabolism and is responsible for fluid regulation (osmoregulation) and behavioural functions .

What does high prolactin mean in men?

A condition in which too much prolactin circulates in the blood is called hyperprolactinaemia.

The most common causes of elevated prolactin in men are:

drugs that reduce the effects of dopamine in the body,
medication given for depression or psychosis,
medication for high blood pressure,
extreme physical exertion,
hypothyroidism,
stress,
benign pituitary tumours (so-called prolactinomas).

Prolactinoma develops when one of the normal prolactin-producing cells in the pituitary gland is mutated. The mutation allows the cell to divide repeatedly, resulting in a large number of cells that produce excessive amounts of prolactin. Most tumours are small - they usually do not exceed 1 cm. The pressure of the tumour can cause headaches and vision problems.

Symptoms of hyperprolactinemiaii may include:

undesirable milk production (even in men),
gynaecomastia,
and symptoms resulting from testosterone deficiency - these can include:
- - - impotence (inability to obtain an erection during intercourse),
    - reduced desire for sex,
    - production of a reduced number of sperm or cessation of sperm production .

Lowering prolactin in men with this condition offers the chance to restore fertility-related functions.

Elevated prolactin - diagnosis and treatment

Prolactin levels are measured by a blood test. Levels are sometimes higher if the patient has eaten before the test, exercised or is under stress. For this reason it is recommended to perform the test on an empty stomach and after a long, good night's sleep. You may also need to stop certain medications before the test, so consult your doctor about any preparations you are taking. If blood tests show high levels of prolactin, your doctor may order an MRI scan of your brain to check for a pituitary tumour .

The treatment of high prolactin in men depends on the cause. The vast majority of patients with hyperprolactinaemia can be effectively treated with drugs that mimic the action of dopamine. The most commonly used drug is cabergoline. Bromocriptine can also be used for treatment. If the cause of prolactin problems is hypothyroidism, therapy will be based on thyroid hormone replacement drugs. Another cause of elevated prolactin may be regular medication for another condition. If this is the case, the doctor will work with the patient to find another medication or add a medication to help lower the hormone.