QuestionQUESTION: hey dr ramirez
i have a question . last week i took a hormone blood test everything was normal except for prolactin its 34.3 wat exactly does that mean and wat do i do.
my other question is wat hormone wood be high if i had PCOS
thank u
ANSWER: Hey Stella,
A prolactin level of 34.3 is elevated. The normal is up to 20. However, prolactin is a very volatile hormone and can be influenced by many different things. For that reason, it needs to be repeated and should be done fasting, first thing in the morning and preferably at a time when your stress is low. An elevated prolactin indicates an abnormality of the pituitary, where all hormone precursors are formed. This can affect your other hormones and your ability to become pregnant. It needs to be normal. When it is only slightly elevated, like yours, that indicates that there could be some increased cell growth and medication is usually all you need. When it is greatly elevated (over 100), that indicates that a tumor could be present and needs to be evaluated. Sometimes, surgery is required.
Some, not all, patients who have PCOS have an increased LH to FSH ratio (LH/FSH). This is where the LH hormone is two to three times higher than the FSH. The ratio should be equal or close to 1. You won't see abnormal levels, however. The levels will be in the normal range, so PCOD cannot be diagnosed only by lab tests. In general, it is a clinical diagnosis based on symptoms. Not all patients have all the signs of PCOD.
I hope this helps,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
---------- FOLLOW-UP ----------
QUESTION: hi so would an mri of the brain be needed or necessary and also wat r the symtoms of pcos bec two doctors r tellin me 2 different things one is saying i do and 1 is saying i dont so how do i know for sure
thank u so much for ur time
gd bless
AnswerHi Again,
An MRI is not needed or necessary or warranted with this low level of prolactin.
In terms of PCO, any of the following symptoms or signs qualify but the hallmarks is irregular menstrual cycles. As I said before, it is a "clinical diagnosis" which means its based on the symptoms and signs and not any specific test. PCO patients have some or all of the following:
Irregular menstrual cycles
Elevated LH/FSH ratio (i.e. LH is higher than FSH)
Elevated insulin levels
characteristic ovaries on ultrasound showing an abundance of antral follicles.
Obesity or increased weight gain
Hirsuitism (increased facial or chest hair growth)
Diabetes
Sensitivity to injectable fertility medications
No other reasons or sources for the ovarian dysfunction.
Sincerely,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
