Prolactin is a hormone that control many
chemical processes in body. The most important and key process is the lactation
initiation. Another not less important is during the strong mother – child bond
creation which failure can cause possible mother absence for a little
child.
In normal life prolactin doesn’t play such an
important role. It production is major during night time mainly in REM sleep
stage. During daytime it is mainly used during the psychical balance
disturbance and coming stress situation. It means that its main purpose is to
get the organism ready to cope with an upcoming stress situation. The place of
its origin is the hypophysis in brain.
Hyperprolactemy – it is an increased prolactin
level contained in blood. This increased production mostly causes menstrual
cycle disturbances where usually goes completely away. This is caused by the
prolactin’s effect that blocks eggs grow process (This is a main cause in the
10% of the cases).
Precautions in hyperprolactemy
If the woman fails to conceive it is necessary
to perform some examinations before the treatment process itself. These
examinations include blood tests. Blood test for the prolactin level should be
performed during morning time approximately 2 hours after the wake up when the
physiological prolactin level is still low and does not distort results. If the
high prolactin level is confirmed the treatment follows. The treatment is usually
in form of pills that lower the prolactin level.
For some women it is possible to determine
clear cause of the trouble. This cause is usually non-benign cancer of the hypophysis
in brain. If the tumor is smaller than 10cm (3.9inch) it is the
microprolactinom. Tumor bigger than 10mm (3.9inch) is called macroprolactinom.
In this case the pharmacological treatment is used as well. This treatment not
only leads to lowering the level of created prolactin but also the total amount
of prolactin in the body. In more rare cases, where the pharmacological
treatment is not successful is possible to use radiotherapy using Laksell´s
gamma knife.
How to recognize higher production of
prolactin? (Hyperprolactemy)
·
Menstrual
disorders (total disappearance of menstrual cycle)
·
Problems
in conceiving
·
Sensitivity
and pain in the breast area
·
Secretion
from one or both breast
How to recognize lower production of prolactin?
(Hypoprolactemy)
·
Usually
not even recognized
·
Troubles
with the beginning of lactation (or no lactation at all)
Because prolactin is a stress hormone, it is true
that the more woman is stressed out the more prolactin level increases and with
longer periods of these episodes the issue can become chronic. That’s why the
best prevention for the infertility caused by any reason is the calm and well
balanced environment.
Another reason for infertility might be endometriosis
Endometriosis is the common reason for the
women infertility. It is a chronic disease characteristic for its endometrium
outside of the vaginal area. It is quite a common disease that affects
approximately 5-10% of women population in reproductive age. Up to 70% is
recidivist.
Endometriosis symptoms:
·
Irregular
painful menstruation
·
Pain
during sexual intercourse (can lead to its refusal)
·
Chronic
pain of stomach
·
Fertility
issues
Endometriosis and
infertility
One of the complications of endometriosis is
the lowered throughput of fallopian tubes and lower production of ovulocytes in
ovaries that can lead to the total infertility. Endometriosis occurs in 7-10%
of women in their reproductive age. Incidence
for women that are already treated for infertility is 6-8 times higher.
Endometriosis
treatment
Endometriosis is hormonally dependent illness
and so the primary treatment should always be hormonal. If needed the solution
is always to undergo a surgical treatment or use analgesics treatment that
should be just a supplementary treatment for hormonal treatment.
Main target for the hormonal treatment is to
temporarily cancel menstruation and thanks to that suppress the endometrium growth
outside of the vaginal area. This will lower and eventually kill the core cells
of the endometrium outside of the vaginal area. If this procedure is successful
the woman health state will rapidly improve.
At present day there is no way to completely cure
endometriosis. According to recent statement of American Society for
Reproductive Medicine endometriosis should be assessed as chronic illness,
requiring all life therapeutical plans having in mind maximum use of
pharmacological means and limited repetition of surgical procedures.
The most common
reasons for infertility:
·
Disturbances
in menstrual cycles, with amenorrhea – when woman will stop menstruating in the
time of her menstrual cycle
·
Syndrome
of polycystic ovaries – excessed number of little follicles is produces in
ovaries, that are not able to fully grow thanks to the hormonal misbalance
·
Hyperandrogenal
syndrome – increased level of man hormone
·
Post
pill amenorrhea – long time use of hormonal protection that can lead to the
loss of menstruation
·
Women
that are extremely thin or with excessive overweight or physical load
(professional sportswomen)
Ovarian function
failure
Ovarian failure is an ovarian function failure
for women before their forties.
The lowered function of the ovaries tissue can
be caused by the repeated ovarian operation (when removing cysts from ovaries
endometriosis)
Morphologically
conditioned infertility
This type of infertility is usually connected
with the lowered throughput of the fallopian tubes. These are usually caused by
gynecological inflammations (adnextidis), after repeated stomach operations and
also for other than gynecological reasons (for example Crohn disease).
Morphologically conditioned infertility can start from endometriosis.
Congenital infertility
Is usually caused by Turner´ syndrome, where
the woman is missing one genital chromosome X, which causes that ovaries are
not fully evolved and can´t fulfill their natural function.
Immunological
infertility
Immune system of some women creates antibodies
against the man´s sperm or against own ovaries. These antibodies are the main
reason for infertility.
Drugs effect
Problems with conception can be also caused by
some drugs. For example “The syndrome of uncracked follicle” where the egg is
not released from the mature follicle. This might be caused by some painkillers
(inhibitors of prostaglandin synthesis).
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