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[Rose B]

Hi
Does anyone know what impact excessive prolactin levels have on absorption of oestrogen?

I have just had the oestrogen part of my HRT increased again because my levels are still too low.  I have had mildly elevated prolactin due to a pituitary problem (  microadenoma) for several years.  This is monitored annually by an endocrinologist and doesn't need treatment.  However, since I have increased my oestrogen, my prolactin levels have tripled.  My HRT consultant tells me that my high prolactin will be inhibiting my absorption of oestrogen.  Anyone know anything about this?

I have researched it a bit and looks like this could be true, but also remember my endo telling me that if I went on HRT, I should get my prolactin checked after 6 weeks as the HRT might make it increase.  I am awaiting an endo appt, but would like to be a bit  informed before I go since endo told me not to bother with HRT at my age (then 54)!

[Dancinggirl]

Hi Rose B
I know nothing about this but Hurdity (she regularly posts on this site) might be able to help.  Hurdity has a biology degree so has a good understanding of this kind of thing.  You may be able to message her but hopefully she'll see your post and respond. Do keep us posted about your progress.  DG xxx

[Hurdity]

Hi Rose B

Sorry I can't answer your question - this is a very specialised area and my knowledge is only very general - in common with most others in the site (but thanks for the confidence Dancinggirl!).

A quick Google came up with this Wikipedia entry as I presume you have already done:

"Hypersecretion is more common than hyposecretion. Hyperprolactinemia is the most frequent abnormality of the anterior pituitary tumors, termed prolactinomas. Prolactinomas may disrupt the hypothalamic-pituitary-gonadal axis as prolactin tends to suppress the secretion of GnRH from the hypothalamus and in turn decreases the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary, therefore disrupting the ovulatory cycle.[29] Such hormonal changes may manifest as amenorrhea and infertility in females as well as impotence in males."

https://en.wikipedia.org/wiki/Prolactin

It seems from this as you have been told that the increased prolactin decreases FSH and LH which will prevent ovulation and therefore will reduce oestrogen levels. Not sure how it will affect absorption though  . I mean the whole point about adding it artificially (like with any HRT) is to compensate for the fact that we are not producing it ourselves so I would have thought? Maybe something to do with oestrogen receptors and the detailed mode of action? Sorry - this is completely beyond me - and presumably it is also not clear from your consultants?

By the way when you say your levels are too low - are you suffering from symptoms such as flushes and sweats despite being on HRT?

Hope you find a solution soon.

Hurdity x

[Rose B]

Thanks for your replies.  Realised its not run of the mill stuff.  Hopefully, my endo will be able to add something useful.
 
Re levels too low - its interesting - I mentioned to HRT consultant, that although my hot flushes had stopped, I hadn't noticed any other improvements.  I am also getting intermittent sweatiness again. My bloods were checked and subsequently now told level is too low to be getting the full benefit.  Not sure I will know if I am feeling whatever the full benefit is, but some improvement to my irritability would certainly be welcome (espec for long suffering OH ) I am also taking it for cardio vascular protection,  as I have a poor family CV history . Realise this is a bit controversial, but consultants at Chelsea and Westminster menopause clinic assure me they would recommend I take HRT long term even if i didn't want it for menopausal symptoms. 

Guess I will just have to wait it out and see if I start to see any other improvement.

RB x