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Parlodel for hyperprolactinemia and its relationship with fertility

Hyperprolactinemia is one of female infertility main causes. This condition involves higher levels of the hormone prolactin in the blood. Prolactin is responsible for stimulating the production of breast milk after childbirth, so it is normal in this period, but in women outside of pregnancy and postpartum it can affect fertility.

 

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What is prolactin?

Prolactin is a protein hormone made by the pituitary gland located in the pituitary gland in the center of the brain. In addition to the production of breast milk during pregnancy and lactation, it is responsible for the breasts growth and the progesterone synthesis in the corpus luteum.

This hormone also has an inhibitory effect on the gonadotropins secretion (responsible for ovulation and the ovarian cycle stimulation), so prolactin hypersecretion can cause absence of menstruation and fertility disorders.

Some factors such as stress and lack of sleep influence prolactin secretion.

 

What is hyperprolactinemia?

Outside of pregnancy and postpartum, prolactin levels should be 2.3 to 25 ng/ml (nanograms per milliliter), while pregnant women can have 80 to 400 ng/ml. Elevated levels of prolactin are called hyperprolactinemia, which is usually caused by a prolactin producing tumor in the pituitary gland called a prolactinoma.

Prolactinomas are benign tumors most often found in the pituitary gland. Although they usually also affect men, they are more frequent in women and their manifestation is the milk production not associated with pregnancy or lactation, a condition known as galactorrhea.

 

 Hyperprolactinemia Symptoms

Many women have elevated prolactin levels and do not experience any symptoms, while others may experience irregular menstrual bleeding, galactorrhea, lack of sexual desire, and infertility.

 

Relationship of hyperprolactinemia with fertility

  • Lack of ovulation. Prolactin is an inhibitor of the hormones necessary for ovulation: gonadotropins and Follicle Stimulating Hormone (FSH).Hyperprolactinemia generates alterations in the menstrual cycle and ovulation, as well as the menstruation and ovulation absence.
  • Corpus luteum deficiency. The corpus luteum is a dynamic tissue that forms itself from the follicle remnant after the oocyte has been released from the ovarian follicle. Its function is to produce progesterone in order to maintain pregnancy in the early stages, until the placenta forms. Hyperprolactinemia can cause a deficit of the corpus luteum, which is responsible for failure to conceive, or spontaneous abortions. 

 

Hyperprolactinemia Causes

Outside of pregnancy and lactation, in 30% of cases, hyperprolactinemia is idiopathic, which means, of unknown causes. However, associated risk factors have been detected, such as:

  • Psychological conditions. Stress, depression, insomnia.
  • Bad life habits. High carbohydrates and fats diets, lack of physical exercise.
  • Prolactinomas. The higher the prolactin levels, the more likely the cause is a pituitary tumor.
  • Some drugs such as anxiolytics, antidepressants, opiates and antiemetics.
  • Other diseases such as kidney failure, epilepsy and hypothyroidism.

 

Parlodel as a treatment for hyperprolactinemia to improve fertility

When a woman wants to get pregnant and has high prolactin levels, the goal is to normalize ovarian function in order to restore ovulatory cycles. In the first instance, if an associated risk factor is detected, such as the consumption of antidepressants, the medication is withdrawn or the disease is treated in the case of hypothyroidism.

In hyperprolactinemia due to unknown causes or due to a pituitary tumor, bromocriptine or Parlodel is the first line medication to achieve prolactin reduction.

Parlodel, bromocriptine, was the first drug used for hyperprolactinemia treatment whose been in use for over 30 years. It is a selective dopaminergic D2 agonist and D1 antagonist and is most commonly used for:

  • Level prolactin values
  • Boost ovulation
  • Normalize menstrual cycles
  • Increase libido
  • Treat galactorrhea
  • Prevent the increase of the pituitary tumor

 

Parlodel is a drug that must be administered by a reproduction specialist to indicate the appropriate dose and if it is necessary to increase each day. Side effects include nausea, vomiting, low blood pressure, and headache, which are often increased when given at a high dose.

The good news is that Parlodel increases your chances of getting pregnant by leveling out prolactin and boosting ovulation.

If you have been diagnosed with hyperlactinemia and you don’t know what to do, schedule your appointment at The Fertility Center. A fertility clinic in Tijuana where you will find fertility specialists, assisted reproduction treatments and procedures to make your dream of being a mother come true.

Schedule your appointment by writing to us through the contact form or through the WhatsApp button, where we will gladly assist you and answer all your questions.

 

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Dr. Jesús Alberto Félix Atondo

Gynecology, Obstetrics and Biology of Human Reproduction Surgeon at the Autonomous University of Guadalajara, specialist Biologist of Human Reproduction by the Mexican Institute of Infertility.

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