Patient's question:
Detailed medical condition and consultation purpose: My PRH value is 64, while the normal adult range is 2-25 ng/ml. I had this test 6 days before my period. Is this related to my short and light menstrual periods? Also, could it cause a miscarriage? I have had two miscarriages in the past, and no cause was found.Duration and course of the current illness: 3 years
Current general condition: Light menstrual flow, short menstrual period.
Medical history: Had two induced abortions in early 1999 and late 2000, and two miscarriages in late 2001 and late 2002. Started treatment in late 2003 and have been treated until now.
Previous diagnoses, treatments, and outcomes: From May to July 2005, I took traditional Chinese medicine, which improved my menstrual cycle, but it returned to normal after I stopped taking it. I am currently taking it again, but it is not working.
Ancillary tests: Ultrasound is good, with normal results.
Doctor's answer:
Hello:●● Prolactin is a polypeptide hormone secreted by specialized cells concentrated on both sides of the posterior pituitary gland, and it originates from the same cells as growth hormone. Prolactin secretion is pulsatile, with significant variations throughout the day. Within one hour of sleep, the amplitude of prolactin pulses rapidly increases, and then during sleep, the secretion level remains high. After waking up, it begins to decline. At 3 or 4 a.m., the serum concentration of prolactin is twice as high as at noon.
●● Prolactin secretion is influenced by multiple factors. Additionally, drugs such as progesterone, dexamethasone, and cortisol, as well as acute stress situations like intense physical activity or trauma, can increase prolactin secretion.
●● Some drugs can also cause elevated prolactin levels. Long-term use of drugs like reserpine, chlorpromazine, or morphine can inhibit the release of prolactin-inhibiting factor by altering the production, absorption, and metabolism of dopamine, leading to excessive prolactin secretion and resulting in amenorrhea and galactorrhea. Oral contraceptives can increase prolactin secretion by the pituitary gland while reducing gonadotropin levels, which may lead to amenorrhea and galactorrhea. Some women on oral contraceptives may have difficulty conceiving immediately, and this is often the reason.
●● Other conditions can also cause elevated prolactin levels. Diseases such as primary hypothyroidism, idiopathic hypogonadotropic hypogonadism, primary hyperthyroidism, renal insufficiency, and bronchial cancer can also lead to increased prolactin levels.
●● One of the main causes of hyperprolactinemia is a pituitary tumor. This occurs because the tumor is composed of cells that secrete prolactin, and these cells are in an uncontrolled state, producing prolactin without restraint.