Christina Moore, Contributor
Waking Times

Osteoporosis is a condition where the bones lose calcium and become weak and brittle. If the bones lose enough calcium, even the mildest stress, such as stepping wrong, can cause them to fracture. The hip is the most common site of an osteoporosis fracture, but it is also possible to develop fractures in the wrists, spine, and feet. An osteoporosis fracture can be a clean break, all the way through the bone, or a hairline fracture.

Osteoporosis can occur in both genders but is most common in post-menopausal women. It is often caused by the changes in estrogen levels that often accompany aging. However, age alone is not the only culprit. There is another hormone, called prolactin, which can contribute to osteoporosis in people of all genders and ages.

What is Prolactin?

Prolactin is one of the sex hormones produced by the pituitary gland. Although both males and females make prolactin naturally, it is primarily responsible for milk production. Under normal circumstances, men produce 2 – 18 ng/mL and non-pregnant women produce 2 – 29 ng/mL of prolactin. Pregnant women produce 10 – 209 ng/mL prolactin as their bodies prepare for birth and breast feeding.

When prolactin levels are higher than normal, it can cause abnormal milk flow, breast tenderness, and disrupt the menstrual cycle in women, it can cause impotence in men, and it can also cause a reduced sex drive, vision problems, headache, and infertility in both genders.

Prolactin can also cause osteoporosis in both genders.

How Prolactin Causes Osteoporosis

All of the sex hormones work together to maintain balance within the body; when one hormone increases, the others often decrease. Additionally, certain hormones serve specific functions and are only at certain levels during certain times of the menstrual cycle.

Prolactin is only released in higher levels during pregnancy. When prolactin levels increase, it signals that a pregnancy is present and causes the body to reduce other hormones to protect the pregnancy; estrogen is one of the hormones that are reduced by the increase in prolactin levels.

Estrogen also helps your body deposit calcium into your bones. When estrogen levels are low, your body doesn’t deposit calcium as well, which leads to osteoporosis.

In men, increases in prolactin production can cause them testosterone levels to drop. Like estrogen in women, testosterone in men contributes to bone mass. When testosterone levels are low, men’s bodies don’t deposit calcium as well, which leads to osteoporosis.

What Causes High Prolactin Levels

The most common cause of abnormally high prolactin levels is a tumor on the pituitary gland. Called a prolactinoma, these types of tumors are often benign – meaning they are noncancerous. However, although they are benign, they can still be disruptive and dangerous to your health.

If the tumor grows big enough, it can cause pressure inside the skull and even damage your vision.

Prolactinomas are the most common type of pituitary tumor, and they occur most often in people under age 40. While women are five times more likely to develop them, men are more likely to develop larger tumors.

Prolactinomas are often treated with medications that counter the effects of the tumor and return your prolactin levels to normal. However, prolactinomas that have grown too large may require endoscopic surgery.

Other Causes of High Prolactin

The brain chemical dopamine actually regulates prolactin production in the pituitary. Other tumors, certain medical conditions, and even certain medications can all affect dopamine production and contribute to higher prolactin levels.

The pituitary tumors that cause acromegaly and Cushing’s syndrome can also block dopamine and increase prolactin production.

Hypothyroidism can also trigger an increase in thyroid levels, and it’s not unusual for doctors to test the prolactin levels in their patients with thyroid disease.

Certain medications can also cause a rise in prolactin levels, especially drugs that block the brain chemical dopamine such as:

• Tranquilizers like trifluoperazine and haloperidol;
• Drugs used to treat gastroesophageal reflux, like metoclopramide;
• Drugs used to treat nausea caused by cancer treatments, including marijuana; and
• Drugs used to treat hypertension.

Additionally, an injury to the chest wall and breast stimulation can both trigger increased prolactin levels.

In most cases, the treatment will depend on the condition.

Someone with a different pituitary tumor might need to take medication, or have surgery to remove that tumor. They might also need medication to treat the increased prolactin levels in addition to the tumor treatment.

Treatments for hypothyroidism, such as levothyroxine pills, could resolve the high prolactin levels, without additional treatment.

Someone taking medications that block dopamine might have to change medications, or might have to take an additional medication to counter the dopamine-blocking effects of the first medication.

Diagnosing High Prolactin and Prolactinoma

High prolactin levels are usually diagnosed through a blood test. The doctor could also order a brain scan to check for a pituitary tumor. If the brain scan does not show a tumor, he could check for medications and other illnesses that could be causing the increased prolactin levels.

If he does discover a tumor, he could check your vision and conduct other tests to determine of the tumor is causing other complications and needs to be removed.

Outlook

The outlook for high prolactin levels is very good. Most prolactinomas respond well to medication, and proper treatment can reverse many of the effects of the high prolactin including the osteoporosis.

Tumors that don’t respond well can be surgically removed using minimally invasive methods, such as endoscopic surgery. However, patients need to be aware that prolactinomas can come back, so they will need regular screening after surgery.

The success of treatments for non-prolactinoma increases in prolactin levels varies depending on the type of treatment.

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