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پرولاکتین چیست؟

آزمایش پرولاکتین (PRL) سطح پرولاکتین را در خون اندازه گیری می کند. پرولاکتین از ترکیب << پرو >> به معنای تولید کردن و << لاکتین >> به معنای شیردهی یا شیر تشکیل شده است. پرولاکتین هورمونی است که توسط غده هیپوفیز که درست زیر مغز شما قرار دارد ساخته و ترشح می شود.

سیستم عصبی مرکزی، سیستم ایمنی، رحم و غدد پستانی نیز قدر به تولید پرولاکتین هستند. عوامل زیر به ایجاد پرولاکتین در بافت ها کمک می کند عبارتند از:

• تحریک نوک پستان
• ورزش
• فشار روانی

هورمون های دیگری مانند پروژسترون، دوپامین (یک ماده شیمیایی مغز) و استروژن (هورمون) سطح پرولاکتین کنترل می کنند.

هنگامی که زنان باردار هستند یا به تازگی زایمان کرده اند، سطح پرولاکتین آنها افزایش می یابد تا بتواند برای شیردهی شیر بسازند به همین علت به آن هورمون شیر هم گفته می شود. رشد بافت پستان به دلیل همین هورمون می باشد. به طور معمول مقادیر کمی پرولاکتین در خون مردان و زنان وجود دارد، اما گاهی ممکن است باردار نباشید و حتی اگر مرد باشید، سطح این هورمون بالا برود. برای اطلاعات بیشتر در مورد هورمون پرولاکتین و راه های پیشگیری از سطح بالای آن با ما همراه باشید.

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هیپرپرولاکتینمی چیست ؟

هیپرپرولاکتینمی به پرولاکتین بیش از حد در خون زنان غیر باردار و در مردان گفته می شود. هیپرپرولاکتینمی در زنان شایع تر می باشد. حدود یک سوم زنان در سال های باروری با پریودهای نامنظم اما تخمدان های طبیعی، هیپرپرولاکتینمی دارند. هنگامی که سطح این هورمون در زنان بالا برود ممکن است برای بادراری مشکل ایجاد شود. یکی دیگر از نشانه ها تولید شیر در سینه مردان و سینه زنان خارج از بارداری شود (گالاکتوره). حدود 90 درصد از زنان مبتلا به گالاکتوره، هیپرپرولاکتینمی دارند.

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نقش هیپرپرولاکتینمی در خون چیست؟

سطوح بالای پرولاکتین با تولید طبیعی سایر هورمون ها مانند استروژن و پروژسترون تداخل می کند و می تواند در زنان تخمک گذاری (آزاد شدن تخمک از تخمدان) را تغییر داده یا متوقف کند و همچنین می تواند به پریود های نامنظم منجر شود.

در مردان سطح بالای پرولاکتین می تواند منجر به گالاکتوره، ناتوانی جنسی (ناتوانی در نعوظ در حین رابطه جنسی)، کاهش میل جنسی و ناباوری شود. یک مرد مبتلا به هیپرپرولاکتینمی درمان نشده ممکن است اسپرم کمتری تولید کند یا اصلا اسپرم تولید نکند.

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دلایل درخواست آزمایش هورمون پرولاکتین در مردان و زنان

در صورت داشتن علائم زیر پزشک این آزمایش را تجویز می کند:

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علت های بهم ریختگی پرولاکتین

به طور معمول، مردان و زنان غیر باردار فقط مقدار کمی از پرولاکتین در خون خود دارند. علل زیر باعث افزایش سطح پرولاکتین می گردد عبارتند از:

• پرولاکتینوما (یک تومور خوش خیم در غده هیپوفیز که پرولاکتین بیش از حد تولید می کند.)
• بیماری های موثر بر هیپوتالاموس (بخشی از مغز که غده هیپوفیز را کنترل می کند.)
• بی اشتهایی (اختلال خوردن)
• داروهایی که برای درمان افسردگی، روان پریشی، فشار خون بالا، تهوع و استفراغ یا حاوی مواد افیونی استفاده می شوند.
• آسیب یا تحریک قفسه سینه (جای زخم، زونا یا سوتین خیلی تنگ)
• بیماری کلیوی، نارسایی کبد
• سندرم تخمدان پلی کیستیک (عدم تعادل هورمونی بر تخمدان ها تاثیر می گذارد.)
• حملات صرع
• کم کاری تیروئید
• رابطه جنسی
• الکل
• استرس یا ورزش (شدید)
• تحریک نوک پستان بی ارتباط با شیردهی
• انجام پرتو درمانی برای از بین بردن تومورهای نزدیک هیپوفیز
• علائم بروز یائسگی
• سندرم زین خالی (جمجمه کاملا با مایع مغزی نخاعی پر شده است و غده هیپوفیز کوچک است.)
• گیاهان دارویی مانند شنبلیله، دانه رازیانه، شبدر قرمز

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نام های دیگر این آزمایش 

• آزمایش PRL
• Prolactin
• آزمایش خون پرولاکتین
• لاکتوتروپین

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محدوده نرمال هورمون پرولاکتین

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جواب آزمایش پرولاکتین ساده است و میزان هورمون موجود در خون را اندازه گیری می‌کند. این می‌تواند بررسی کند که آیا سطح این هورمون در بدن افراد بسیار پایین یا خیلی زیاد است.

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تست هورمون پرولاکتین چگونه انجام می شود؟

اپراتور آزمایشگاه با استفاده از یک سوزن کوچک از رگ بازوی شما نمونه خون می گیرد و داخل یک لوله آزمایش یا ویال جمع آوری می کند. هنگامی که سوزن داخل یا خارج می شود ممکن است کمی احساس سوزش کنید که معمولا کمتر از 5 دقیقه طول می کشد.

آزمایش خون می تواند سطح پرولاکتین را اندازه گیری کند. اگر اخیرا غذا خورده اید یا تحت استرس شدید  هستید، گاهی اوقات سطوح پرولاکتین بالاتر است. ممکن است بعد از ناشتا بودن و ریلکس شدن، آزمایش دوباره انجام شود.

اگر سطح پرولاکتین پس از بررسی دوم همچنان بالا باشد، پزشک ممکن است برای بررسی وجود تومور غده هیپوفیز،  MRI از مغز را تجویز کند.

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 بهترین زمان آزمایش پرولاکتین

پیشنهاد می شود این آزمایش در اوایل صبح 3 الی 4 ساعت پس از خواب شامگاهی و ناشتا گرفته شود زیرا استرس، دارو و خوردن غذا بر سطح این هورمون که در طول روز تاثیرگذار می گذارد.

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پرولاکتین بالا چگونه درمان می شود؟

درمان بستگی به علت دارد. اگر علتی پیدا نشد یا تومور غده هیپوفیز دارید، درمان معمول دارو است. کم کاری تیروئید با داروهای جایگزین تیروئید درمان می شود و همچنین باید سطح پرولاکتین را به حالت عادی بازگرداند.

اگر داروی معمولی شما دلیل سطح بالای پرولاکتین شما باشد، پزشک با همکاری شما داروی دیگری را پیدا میکند یا داروی دیگری را برای کاهش سطح پرولاکتین اضافه می کند.

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اهداف درمان پرولاکتین بالا عبارتند از:

• بهبود کیفیت زندگی
• بازگرداندن تولید پرولاکتین به سطح نرمال
• بازگرداندن عملکرد طبیعی غده هیپوفیز
• کاهش اندازه تومور هیپوفیز
• از بین بردن عوارض فشار تومور مانند سردرد یا مشکلات بینایی

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 بهبود کیفیت زندگی

راه های طبیعی برای متعادل کردن سطح این هورمون وجود دارد.

وقتی نوبت به درک سلامت و هورمون های ما می رسد، هر عملی در بدن، علت ریشه ای دارد. وقتی به سوال چه چیزی باعث تحریک عدم تعادل (علائم ظاهر در بدن) می گردد پاسخ می دهیم، متوجه می شویم با پرداختن به علت اصلی می توانیم به درمان طولانی مدت و پایدار دست پیدا کنیم.

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1- استرس

وقتی استرس داریم سطوح بالایی از کورتیزول در بدن ترشح می شود که یک هورمون استرس است. بدن ما در هر حال در تلاش برای زنده ماندن با توجه به شرایط تهدید کننده است، بنابراین بدن تلاش می کند در پاسخ به این هورمون ترشح شده مبارزه کند. در هنگام استرس سطوح بالای پرولاکتین برای ایجاد هموستاز در شرایط استرس بالا آزاد می شود. سیستم ایمنی بدن در پاسخ به استرس کند می شود و پرولاکتین دارای اثرات تنظیمی برای کمک به بهبود سیستم ایمنی است. به همین دلیل استرس می تواند عامل افزایش پرولاکتین باشد.

یک مطالعه نشان داد که زنانی که در معرض آسیب های دوران کودکی قرار گرفته اند، احتمال بیشتری دارد که پرولاکتین بالایی در زندگی آینده خود داشته باشند. استرس می تواند ناشی از محیط شغلی، مشکلات خانوادگی، ورزش بیش از حد باشد و یکی از موارد رایج استرس ناباوری است.

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2- ورزش

در یک مطالعه سطح پرولاکتین را در ورزشکاران زن که ورزش دوچرخه سواری و دویدن را انجام داده بودند مورد بررسی قرار گرفت و به دست آمد که آستانه ای برای میزان ورزش زنان قبل از رسیدن به سطوح بالای پرولاکتین وجود دارد.

و در مطالعه ای دیگری، از زنان خواستند که هر روز به مدت 6 روز در هفته، هر روز یک ساعت، در مجموع 8 هفته یوگا انجام دهند. میانگین سطح پرولاکتین قبل از یوگا 5/80 و بعد از 8 هفته 17/63 بود. افزایش پرولاکتین با بسیاری از مسیرهای عصبی که بر سطح پرولاکتین تاثیر می گذارد، مرتبط است.

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transform_translate_x=”0″ transform_translate_y=”0″ transform_rotate=”0″ transform_skew_x=”0″ transform_skew_y=”0″ transform_scale_x_hover=”1″ transform_scale_y_hover=”1″ transform_translate_x_hover=”0″ transform_translate_y_hover=”0″ transform_rotate_hover=”0″ transform_skew_x_hover=”0″ transform_skew_y_hover=”0″ transform_origin=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” last=”true” border_position=”all” first=”true” spacing_right=””][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”” rule_size=”” rule_color=”” hue=”” saturation=”” lightness=”” alpha=”” content_alignment_medium=”” content_alignment_small=”” content_alignment=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” class=”” id=”” margin_top=”” margin_right=”” margin_bottom=”” margin_left=”” fusion_font_family_text_font=”” fusion_font_variant_text_font=”” font_size=”” line_height=”” letter_spacing=”” text_transform=”” text_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]

3- مدیتیشن

مدیتیشن یک تمرینی ذهنی است که در آن به بدن خود گوش می دهید و به حرکات خود توجه می کنید. مدیتیشن ذهن شما را تشویق می کند به جای اینکه بدنتان را مجبور به انجام کاری کنید فقط به این دلیل که فکر می کنید عادی برای ورزش کردن است، به تمریناتی که بدنتان می خواهد انجام دهد گوش بدهید. به عبارتی دیگر به ذهن و بدن خود گوش دهید و در عین حال از هرگونه فکری که حواس تان را پرت کند اجتناب کنید. این ورزش روحی برای کاهش طبیعی پرولاکتین مفید است زیرا استرس را از بین می برد.

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4- هضم غذا

بعد از خوردن یک وعده غذایی، هضم غذا می تواند سبب افزایش سطح پرولاکتین شود. مطالعات نشان داده اند که پروتئین، درشت مغذی است که باعث افزایش پرولاکتین می شود. بنابراین خوردن یک وعده غذایی با پروتئینی کمتر می تواند برای کاهش سطح پرولاکتین مفید باشد.

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5- مقاربت جنسی

یک مطالعه نشان داد که هم مردان و هم زنان پس از مقاربت جنسی سطح پرولاکتین آن ها افزایش می یابد، البته مشخص گردید که خودارضایی عامل افزایش پرولاکتین نیست.

علاوه بر این، یک پرسشنامه برای زنان با سطوح بالا و نرمال پرولاکتین تهیه گردید. نتایج نشان داد که زنانی با نارضایتی جنسی، ارگاسم و برانگیختگی دارند همگی سطوح بالای از پرولاکتین داشتند.

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hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” class=”” id=”” margin_top=”” margin_right=”” margin_bottom=”” margin_left=”” fusion_font_family_text_font=”” fusion_font_variant_text_font=”” font_size=”” line_height=”” letter_spacing=”” text_transform=”” text_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]

6- تیروئید

بسیاری از مطالعات نشان داده اند که زنان با پرولاکتین بالا ممکن است به بیماری تیروئید مبتلا باشند. بیماری تیروئید میزان تولید هورمون های تیروئید را محدود می کند. تولید کم هورمون های تیروئید می تواند باعث افزایش سطح پرولاکتین شود. دلیل  این امر این است که تغییرات ساختاری که در فولیکول های تیروئیدی ایجاد می شود که منجر به تولید سطح بالای پرولاکتین می شود، بنابراین می تواند عملکرد سایر هورمون های جنسی که باعث ناباوری می شود، جلوگیری کند. با مکمل سازی هورمون های تیروئید، سطح پرولاکتین به حالت عادی باز گردد.

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text_transform=”” text_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]

6- الکل

در مطالعه ای نشان داده شده است که در آن شرکت کنندگان 0.5 گرم به ازای هر کیلوگرم وزن بدن الکل مصرف کردند و نتایج نشان دهنده افزایش سطح پرولاکتین بود. این اثر می تواند به دلیل تغییرات حاد سطح دوپامین در هیپوتالاموس باشد.

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راه های درمان پرولاکتین بالا عبارتند از:

دارو

یکی از رایج ترین و موثر ترین روش درمان پرولاکتینوما درمان به کمک داروهایی به نام آگونیست دوپامین، سطح پرولاکتین خون را کنترل می کند، می باشد.

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جراحی

اگر درمان با دارو نتیجه بخش نبود، جراحی گزینه ای دیگر برای حذف تومور می باشد. نوع عمل جراحی به اندازه و گستردگی تومور بستگی دارد.

• جراحی از راه سینوس اسفنویید

در این جراحی تومور از راه حفره بینی برداشته می شود. از آنجایی که هیچ برشی در طول جراحی ایجاد نمی شود این جراحی عوارض کمی دارد.

• جراحی ترانس کرانیال

اگر تومور بیمار بزرگ باشد یا به بافت مغزی نزدیک شده باشد جراح از طریق قسمت فوقانی جمجمه به تومور را بر میدارد. همچنین با نام های کرانیوتومی و جمجمه بری شناخته می شود.

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پرتو درمانی

اگر دارو و جراحی برای کاهش سطح پرولاکتین بیمار موثر نباشد، پزشک پرتو درمانی که گزینه نادری برای درمان است استفاده می کند.

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هورمون تیروئید مصنوعی

در صورت کم کاری تیروئید که می تواند باعث کاهش سطح پرولاکتین (هیپروپرولاکتینمی) شود، با هورمون  تیروئید مصنوعی به حالت طبیعی باز می گردد.

در هر حال به یاد داشته باشید که هر بدنی منحصر به فرد است. تعیین اینکه چه چیزی برای بدن شما بهتر است برای هر فرد متفاوت است و همچنین تغییرات ساده در طولانی مدت تاثیرگذار خود را نشان میدهد.

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 کیت های مورد نیاز : کیت (PRL (48 Tests پیشگامان – کیت پرولاکتین پیشگامان – کیت پرولاکتین PRL ایده ال تشخیص آتیه 

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