Patient's question:
I am 23 years old and have not been pregnant. The test results are: prolactin level is 34.62 g/ml. Is this value high? Does it affect fertility? How should it be resolved?Doctor's answer:
Hello, since elevated prolactin can inhibit the secretion of gonadotropins, leading to impaired follicular development, anovulation, and luteal dysfunction, resulting in infertility. Unstable prolactin secretion can be influenced by various physiological conditions, such as sleep, mood, depression, stress, exercise, sexual intercourse, hunger, and post-meal states, all of which may affect its secretion and cause transient elevations. To rule out these influencing factors, blood prolactin levels are typically measured with fasting blood draw between 9 and 10 a.m. Normal prolactin levels in women of reproductive age range from 5 to 25 g/ml. If prolactin exceeds 35 g/ml, it is considered elevated. In infertile women, if an initial prolactin level is elevated, a second test should be conducted before diagnosing hyperprolactinemia and indiscriminately prescribing medication. For confirmed hyperprolactinemia, thyroid function and thyroid-stimulating hormone should be tested to rule out hypothyroidism. According to relevant data, when PRL exceeds 50 g/ml, 20% of cases involve pituitary tumors, and when PRL reaches 100 g/ml, approximately 50% have pituitary tumors. If PRL exceeds 200 g/ml, it almost certainly indicates the presence of a pituitary tumor. Therefore, when PRL exceeds 50 g/ml, magnetic resonance imaging should be performed to rule out a pituitary tumor.