Prolactin Testing

The purpose of prolactin is to define the cause of infertility in women. The purpose of prolactin test is to measure the level of the hormone prolactin, that is produced by the pituitary gland in your blood.
High levels of prolactin are observed among pregnant women, who prepare their breasts for the production of milk. During pregnancy, prolactin levels can vary and become higher by 10 to 20 times. After the delivery, prolactin maintains the mothers milk production (lactation). Women, who do not breast-feed their babies, observe that their prolactin levels become normal after the delivery of a child. Breast-feeding leads to the higher level of prolactin. Prolactin levels may become again normal some months of breast-feeding afterwards and be the same as normal nonpregnant or non–breast-feeding levels.

Prolactin is produced by the pituitary glands of men and a woman who is not pregnant, its function is not clear. Prolactin levels can change within the day. They are the highest while people sleep and soon after their sleep. Its levels can become higher while people are under physical or emotional stress and while they are sleeping. Some medications lead to higher level of prolactin. Tumors of the pituitary gland are also able to more intensive prolactin production. It should be kept in mind, that a damaged pituitary gland losses its ability to produce required quantity of prolactin.

The purpose of prolactin test is:
1) To get to know why an abnormal nipple discharge and such problem as infertility in a woman appears, why  menstrual periods is not observed (the medical term is amenorrhea),
2) When a pituitary gland problem in a man appears.
3) For the evaluation of a mans sexual desire or why he is unable to have an erection (erectile dysfunction), especially it should be done if his testosterone levels are very low.
4) To find out whether a big quantity of of prolactin is produced by a tumor in the pituitary gland (the medical term is a prolactinoma).

Before having a prolactin test the following recommendations are given:
You should not eat or drink a few hours according to the advice of your doctor before having a prolactin test. A blood prolactin test should be done about 3 hours after your sleep; the recommended time is between 8 a.m. and 10 a.m.
Elevated prolactin levels can be observed after the influence of emotional stress or strenuous exercise. Before the test it is recommended to rest during the period to 30 minutes. Prolactin levels can become higher when you stimulate the nipples. It is forbidden to stimulate the nipples during a period of 24 hours just before the test. Women, who observe abnormal nipple discharge, should avoid eliciting the discharge just before the test.

The procedure of prolactin blood test should be done in such order:
1) The first thing you should do is to wrap an elastic band around your upper arm to prevent the further flow of blood.
) Wrapping an arm leads to the liger size of the veins below the band, that’s why it is better to insert a needle into the vein.
3) Disinfect the sharp side of needle with alcohol.
4) Insert the needle into the vein. It is recommended to have more than one needle stick. Then you should put a tube to the needle to fill it with blood.
5) As soon as the process of blood collection is over, you should take away the band from your arm.
6) As soon as you take away the needle, put a gauze pad or cotton ball over the needle site.
7) Then you should use pressure to the site and then a bandage.

When the doctor insert a needle, it can be hardly noticeable or you may feel a brief sting or pinch at the moment of the needle’s pinching the skin. A stinging pain at the moment of the needle being in the vein can be available among some people. No pain or little discomfort is the most common things when the needle is inserted in the vein. If your doctor is skilled and experienced, you feel little or no pain. Other factors that influence the reaction to pain are the condition of your veins and your sensitivity to pain.

There are very little complications of a prolactin blood test when blood is taken from a vein. A small bruise may occur at the puncture site. To avoid having a bruise, you should keep pressure on the site during some minutes after the withdrawal of the needle.

In rare cases you may observe the inflammation of the vein after the blood sample is taken. The medical term for such procedure is phlebitis and its treatment is a warm compress that is to be put some times every day.

Patients, who have continued bleeding disorders, should be concerned. There are some medicines such as aspirin, warfarin (Coumadin) and other blood-thinning medications, that can cause bleeding. You should inform your doctor before blood test about bleeding or clotting problems and blood-thinning medications, taken by you.

The purpose of a blood prolactin test is to measure the level of prolactin, a hormone that is produced by the pituitary gland. Prolactin levels can be changed during a day. They are the highest when you sleep and just after a sleep.
See at the following tables for the quantity of prolactin available in blood.

 Nonpregnant women: less than 20 nanograms per milliliter (ng/mL)
 Men:  less than 15 ng/mL

High quantity of prolactin is observed under following conditions:
1) High quantity of prolactin (it is as usual more than 200 ng/mL) may lead to a pituitary gland tumor (prolactinoma). People with a high prolactin level are more prone to a pituitary gland tumor. If a prolactin level is more than 200 ng/mL, a magnetic resonance imaging (MRI) test is recommended to be held to confirm the availability of a pituitary tumor.
2) If a prolactin level is normal or low, a pituitary tumor can also be available. If it is available and there is concern of available a pituitary tumor, a magnetic resonance imaging (MRI) test may be held.
3) High levels of prolactin are possible causes of the excessive production by the pituitary gland the hormone when its causes are not known (the medical term is idiopathic hyperprolactinemia). A pituitary gland tumor may also be available to be observed with X-rays or magnetic resonance imaging (MRI). High prolactin levels can be caused by such health problems as pregnancy, liver disease (cirrhosis), kidney disease, and hypothyroidism. You may consult a doctor if there are any abnormal results, symptoms or complications.

The prolactin test and its results can be influenced by such factors as:
1) Repeated and prolong physical or emotional stress or strenuous exercise.
2) Sleep, high levels are observed 3 hours after a sleep.
3) Nipple stimulation.
4) Medications with estrogens in their content (they are available in birth control pills), high blood pressure medications, tricyclic antidepression medications, cimetidine (Tagamet), metoclopramide (Reglan), chlorpromazine (Thorazine), haloperidol (Haldol), methyldopa (Aldomet), and levodopa (Larodopa).
5) Cocaine.
6) Unusual blood draw is a possible cause of elevated prolactin level. 7) When a procedure is done with a radioactive tracer during 1 week of the prolactin test.

Low levels of prolactin are observed within men and women who are not pregnant. A lack of prolactin is connected with unable milk production after pregnancy. Very low level of prolactin is not cured in such cases. Men, who are recommended for having a prolactin test, are a  lack of sexual desire in men or his inability to have an erection (erectile dysfunction), especially if his testosterone levels are low and below the norm. A pituitary gland tumor that is producing prolactin should be treated with bromocryptine (Parlodel), removal by surgery, or radiation therapy. The size of the tumor, the health and age of the person are factors that influence the treatment.