{"id":6956,"date":"2008-01-14T09:22:12","date_gmt":"2008-01-14T07:22:12","guid":{"rendered":"https:\/\/www.synevo.ro\/prolactina-hormon-al-supravietuirii-speciilor-hiperprolactinemiile-o-problema-pentru-femeile-intre-20-50-ani\/"},"modified":"2021-08-25T14:45:13","modified_gmt":"2021-08-25T11:45:13","slug":"prolactina","status":"publish","type":"post","link":"https:\/\/old.synevo.md\/ru\/prolactina\/","title":{"rendered":"Prolactina &#8211; hormon al supravie\u0163uirii speciilor. Hiperprolactinemiile &#8211; o problem\u0103 pentru femeile \u00eentre 20-50 ani."},"content":{"rendered":"<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div><h2 class=\"has-text-color wp-block-heading\" style=\"color:#00539f\">Func\u0163iile biologice ale prolactinei sunt numeroase, dar cele mai impotante sunt:<\/h2><ul class=\"wp-block-list\"><li><strong>activitatea lactogenic\u0103<\/strong> (declan\u015farea secre\u0163iei lactate)<\/li><li><strong>activitatea galactopoetic\u0103<\/strong> (men\u0163inerea produc\u0163iei de lapte).<\/li><\/ul><p>Cercet\u0103rile au ar\u0103tat c\u0103 prolactina nu intervine la pubertate \u00een cre\u015fterea glandei mamare (respectiv a canalelor galactofore), acest proces necesit\u00e2nd prezen\u0163a altor hormoni (estrogeni,corticoizi, insulina, somatotropina).<\/p><div class=\"container synevo-content-box bullet-list\">\n    <div class=\"sycbox-items\">\n        \n                <div class=\"sycbox-item\">\n            <div class=\"sycbox-head\">\n                <div class=\"sycbox-image\">\n                                             <img decoding=\"async\" src=\"https:\/\/old.synevo.md\/wp-content\/themes\/synevo-sage\/resources\/assets\/images\/icons\/icon-health-magnifier.svg\" alt=\"-\">\n                                    <\/div>\n                <div class=\"sycbox-title\">Cum se modific\u0103 nivelul de prolactin\u0103 \u00een cursul vie\u0163ii?<\/div>\n            <\/div>\n            <div class=\"sycbox-description\"><p>La b\u0103rba\u0163i nivelul sanguin de prolactin\u0103 (care este \u00een mod obi\u015fnuit mai mic dec\u00e2t la femei) r\u0103m\u00e2ne relativ constant din copil\u0103rie p\u00e2n\u0103 \u00een perioada de adult \u015fi b\u0103tr\u00e2ne\u0163e.<\/p>\n<p>La femei nivelul sanguin al prolactinei cre\u015fte \u00eencep\u00e2nd cu perioada de pubertate (odat\u0103 cu cre\u015fterea secre\u0163iei de estrogeni) \u015fi scade dup\u0103 menopauz\u0103 (odat\u0103 cu sc\u0103derea nivelului de estrogeni). De aici ne d\u0103m seama c\u0103 principalul factor care stimuleaz\u0103 produc\u0163ia de prolactin\u0103 este estrogenul (\u00een principal cel endogen, dar \u015fi cel exogen, adic\u0103 adus \u00een organism prin medicamente, \u00een special prin anticoncep\u0163ionalele orale).<\/p>\n<p>\u00cen cursul sarcinii nivelul prolactinei cre\u015fte, cre\u015fterea prolactinei o urmeaz\u0103 la un interval de 1-3 zile pe cea estrogenic\u0103. Nivelul prolactinei din s\u00e2nge cre\u015fte progresiv \u00een timpul sarcinii (c\u00e2nd se observ\u0103 \u015fi o cre\u015ftere \u00een volum a glandei hipofizare) ajung\u00e2nd p\u00e2n\u0103 la de 5-10 ori mai mult dec\u00e2t nivelul normal.<\/p>\n<p>Dup\u0103 na\u015ftere, ini\u0163ierea secre\u0163iei de lapte este determinat\u0103 pe de o parte de sc\u0103derea hormonilor sexuali placentari (predominant estrogeni) \u015fi pe de alt\u0103 parte de ac\u0163iunea de suc\u0163iune a mamelonului care induce secre\u0163ia de prolactin\u0103 la un interval de 1-30 minute dup\u0103 supt. Episoadele de supt repetate \u015fi frecvente determin\u0103 men\u0163inerea secre\u0163iei de prolactin\u0103. Nivelul sanguin de prolactin\u0103 scade mai rapid la femeile care nu al\u0103pteaz\u0103, \u00een timp ce la femeile care al\u0103pteaz\u0103 prolactina este crescut\u0103 pentru o perioad\u0103 de 18 luni postpartum. Prolactina interfereaz\u0103 cu revenirea la normal a func\u0163iei ovariene \u015fi ac\u0163ioneaz\u0103 astfel ca un anticoncep\u0163ional natural (majoritatea femeilor nu r\u0103m\u00e2n \u00eens\u0103rcinate \u00een perioada \u00een care al\u0103pteaz\u0103).<\/p>\n<\/div>\n            \n                    <\/div>\n                \n                \n    <\/div>\n<\/div><div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div><h2 class=\"has-text-color wp-block-heading\" style=\"color:#00539f\">Hiperprolactinemiile \u2013 Ce sunt \u015fi care sunt cauzele lor?<\/h2><div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2008\/01\/Prolactina-hormon-sange.jpg\" alt=\"Prolactina-hormon-sange\" class=\"wp-image-17081\"\/><\/figure><\/div><p>Hiperprolactinemia reprezint\u0103 cre\u015fterea nivelului prolactinei \u00een s\u00e2nge peste nivelul maxim admis. Nu vom preciza cifre pentru c\u0103 ele variaz\u0103 de la un laborator la altul \u00een func\u0163ie de metoda de determinare \u015fi de unit\u0103\u0163ile de m\u0103sur\u0103 folosite (dar la eliberarea rezultatului, laboratorul trebuie s\u0103 precizeze domeniul valorilor normale pentru metoda folosit\u0103).<\/p><p class=\"has-text-align-left\"><span style=\"color: #000000;\">Hiperprolactinemiile se \u00eempart \u00een dou\u0103 mari categorii:<\/span><\/p><div class=\"container synevo-content-box bullet-list\">\n    <div class=\"sycbox-items\">\n        \n                <div class=\"sycbox-item\">\n            <div class=\"sycbox-head\">\n                <div class=\"sycbox-image\">\n                                             <img decoding=\"async\" src=\"https:\/\/old.synevo.md\/wp-content\/themes\/synevo-sage\/resources\/assets\/images\/icons\/icon-blood-tests.svg\" alt=\"-\">\n                                    <\/div>\n                <div class=\"sycbox-title\">Hiperprolactinemiile func\u021bionale<\/div>\n            <\/div>\n            <div class=\"sycbox-description\"><p>sarcin\u0103, al\u0103ptare, stimulare mamelonar\u0103, efort fizic<\/p>\n<p>administrarea unor medicamente: estrogeni (anticoncep\u0163ionale orale), antagoni\u015fti dopaminergici (fenotiazine, haloperidol, metoclopramid, rezerpin\u0103, metildopa), opioizi, cimetidin\u0103, verapamil, inhibitor de monoaminoxidaz\u0103<\/p>\n<p>hipotiroidism periferic<\/p>\n<p>insuficien\u0163\u0103 renal\u0103 cronic\u0103<\/p>\n<p>insuficien\u0163\u0103 hepatic\u0103 sever\u0103<\/p>\n<p>stresul prelungit<\/p>\n<\/div>\n            \n                    <\/div>\n                \n                <div class=\"sycbox-item\">\n            <div class=\"sycbox-head\">\n                <div class=\"sycbox-image\">\n                                            <img decoding=\"async\" src=\"https:\/\/old.synevo.md\/wp-content\/themes\/synevo-sage\/resources\/assets\/images\/icons\/icon-blood-tests.svg\" alt=\"-\">\n                                    <\/div>\n                <div class=\"sycbox-title\">Hiperprolactinemiile organice<\/div>\n            <\/div>\n            <div class=\"sycbox-description\"><p>leziuni hipotalamice \u015fi hipofizare<\/p>\n<p>tumori hipofizare<\/p>\n<p>produc\u0163ie extrahipofizar\u0103 de prolactin\u0103 prin tumori ectopice (carcinorm bron\u015fic, hipernefrom, corioepiteliom).<\/p>\n<\/div>\n            \n                    <\/div>\n                \n    <\/div>\n<\/div><p>\u00centr-o prim\u0103 faz\u0103 diferen\u0163a \u00eentre cele dou\u0103 categorii de hiperprolactinemii o face valoarea prolactinei. \u00cen general o prolactin\u0103 cu o valoare mai mic\u0103 dec\u00e2t de patru ori limita maxim\u0103 admis\u0103 poate fi \u00eencadrat\u0103 \u00een hiperprolactinemiile func\u0163ionale. Toate valorile care dep\u0103\u015fesc de patru ori limita superioar\u0103 admis\u0103 intr\u0103 \u00een categoria hiperprolactinemiilor organice. Aceasta \u00eens\u0103 nu este o regul\u0103 deoarece putem avea hiperprolactinemii organice cu valori mai mici (de obicei tumori la debut), dup\u0103 cum valori mai mari se pot datora unor hiperprolactinemii func\u0163ionale. Este rolul medicului endocrinolog de a stabili conduita de investiga\u0163ii (radiologice, tomografie computerizat\u0103, testul de stimulare la TRH) care s\u0103 elucideze definitiv diagnosticul.<\/p><h2 class=\"has-text-color wp-block-heading\" style=\"color:#00539f\">Simptomele hiperprolactinemiilor<\/h2><div class=\"container synevo-content-box box-text-center bullet-list\">\n    <div class=\"sycbox-items\">\n        \n                <div class=\"sycbox-item\">\n            <div class=\"sycbox-head\">\n                <div class=\"sycbox-image\">\n                                             <img decoding=\"async\" src=\"https:\/\/old.synevo.md\/wp-content\/themes\/synevo-sage\/resources\/assets\/images\/icons\/icon-health-magnifier.svg\" alt=\"-\">\n                                    <\/div>\n                <div class=\"sycbox-title\">La FEMEIE simptomele sunt mai u\u015for de recunoscut:<\/div>\n            <\/div>\n            <div class=\"sycbox-description\"><p>tulbur\u0103ri ale ciclului menstrual (\u00eent\u00e2rzieri, diminuare cantitativ\u0103), merg\u00e2nd p\u00e2n\u0103 la amenoree (lipsa menstrua\u0163iei)<\/p>\n<p>infertilitate<\/p>\n<p>galactoree (apari\u0163ia secre\u0163iei lactate \u00een afara perioadei de sarcin\u0103 sau al\u0103ptare)<\/p>\n<p>cefalee (dureri de cap)<\/p>\n<\/div>\n            \n                    <\/div>\n                \n                <div class=\"sycbox-item\">\n            <div class=\"sycbox-head\">\n                <div class=\"sycbox-image\">\n                                            <img decoding=\"async\" src=\"https:\/\/old.synevo.md\/wp-content\/themes\/synevo-sage\/resources\/assets\/images\/icons\/icon-health-magnifier.svg\" alt=\"-\">\n                                    <\/div>\n                <div class=\"sycbox-title\">La B\u0102RBA\u0162I simptomele sunt de obicei nespecifice, motiv pentru care b\u0103rba\u0163ii solicit\u0103 mai rar sau mai t\u00e2rziu un consult medical:<\/div>\n            <\/div>\n            <div class=\"sycbox-description\"><p>tulbur\u0103ri de dinamic\u0103 sexual\u0103 (merg\u00e2nd p\u00e2n\u0103 la dispari\u0163ia poten\u0163ei sexuale)<\/p>\n<p>sc\u0103derea libidoului<\/p>\n<p>infertilitate (spermograma arat\u0103 un num\u0103r mult sc\u0103zut de spermatozoizi)<\/p>\n<p>galactoree \u015fi\/sau ginecomastie (m\u0103rirea s\u00e2nilor) simptome care apar \u00een special la copii<\/p>\n<p>cefalee.<\/p>\n<\/div>\n            \n                    <\/div>\n                \n    <\/div>\n<\/div><div class=\"synevo-shop-products\">\r\n    <div class=\"sysprod\">\r\n        \r\n        <div class=\"sysprod-products\">\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/prolactina\/\">\u041f\u0440\u043e\u043b\u0430\u043a\u0442\u0438\u043d<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>\u0426\u0435\u043d\u0430<\/span>\r\n                        <span>220 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9286\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart\"\r\n                                data-product_id=\"9286\"\r\n                                data-product_sku=\"ME23\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                    <\/div>\r\n        \r\n    <\/div>\r\n<\/div>\r\n\r\n<style>\r\n.synevo-shop-products {\r\n    padding: 24px 0;\r\n    margin: 24px 0;\r\n    border-radius: 10px;\r\n    background: #F6F7F9;\r\n}\r\n.synevo-shop-products .sysprod-product {\r\n    position: relative;\r\n    margin: 0 24px;\r\n    margin-bottom: 24px;\r\n    border-radius: 10px;\r\n    background: #fff;\r\n    display: flex;\r\n    flex-direction: row;\r\n    align-items: center;\r\n}\r\n.synevo-shop-products .sysprod-product:last-child {\r\n    margin-bottom: 0;\r\n}\r\n.synevo-shop-products .sysprod-product-title {\r\n    flex-grow: 1;\r\n    padding: 15px;\r\n    margin-left: 14px;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 16px;\r\n    color: #29263F;\r\n}\r\n.synevo-shop-products .sysprod-product-price {\r\n    flex-shrink: 0;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 18px;\r\n    color: #FDB813;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart {\r\n    flex-shrink: 0;\r\n    position: relative;\r\n    width: 38px;\r\n    height: 38px;\r\n    margin-left: 24px;\r\n    margin-right: 24px;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart .button {\r\n    top: unset;\r\n    right: unset;\r\n}\r\n<\/style><div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2008\/01\/Prolactina-hormon-21.jpg\" alt=\"Prolactina\" class=\"wp-image-17101\"\/><\/figure><\/div><h2 class=\"has-text-color wp-block-heading\" style=\"color:#00539f\">Inciden\u0163a hiperprolactinemiilor<\/h2><p>Doz\u0103rile de prolactin\u0103 au devenit analize uzuale \u00een laboratoarele din zilele noastre. \u00cen fiecare jude\u0163 exist\u0103 m\u0103car un laborator care determin\u0103 nivelul sanguin al prolactinemiei.<\/p><p>Cele mai frecvente doz\u0103ri de prolactin\u0103 sunt efectuate la femei (90%). Inciden\u0163a hiperprolactinemiilor din totalul determin\u0103rilor de prolactin\u0103 este \u00eentre 25-27% din cazuri, din care doar 2% prezint\u0103 valori ale prolactinei ce dep\u0103\u015fesc de patru ori limita superioar\u0103 admis\u0103 (hiperprolactinemii organice).<\/p><p>Din totalul hiperprolactinemiilor 74,8% se \u00eent\u00e2lnesc la femeile \u00eentre 20-50 de ani. Aceste paciente s-au prezentat la endocrinologie sau ginecologie pentru tulbur\u0103ri de ciclu menstrual, galactoree, infertilitate. 50% din femeile cu galactoree foloseau contraceptive orale cu con\u0163inut crescut de estrogeni.<\/p><div class=\"container synevo-content-box box-text-center bullet-list\">\n    <div class=\"sycbox-items\">\n        \n                <div class=\"sycbox-item\">\n            <div class=\"sycbox-head\">\n                <div class=\"sycbox-image\">\n                                             <img decoding=\"async\" src=\"https:\/\/old.synevo.md\/wp-content\/themes\/synevo-sage\/resources\/assets\/images\/icons\/icon-health-magnifier.svg\" alt=\"-\">\n                                    <\/div>\n                <div class=\"sycbox-title\">Ce trebuie s\u0103 face\u021bi?<\/div>\n            <\/div>\n            <div class=\"sycbox-description\"><p>s\u0103 v\u0103 cunoa\u015fte\u0163i propriul organism \u015fi la primele simptome care atrag aten\u0163ia asupra unei tulbur\u0103ri s\u0103 v\u0103 prezenta\u0163i la medicul de familie<\/p>\n<p>dac\u0103 secre\u0163ia lactat\u0103 se prelunge\u015fte mai mult de 18 luni dup\u0103 na\u015ftere s\u0103 v\u0103 prezenta\u0163i la medicul endocrinolog sau ginecolog<\/p>\n<p>s\u0103 nu lua\u0163i contraceptive orale dec\u00e2t la recomandarea medicilor, iar dac\u0103 apar manifest\u0103ri nepl\u0103cute dup\u0103 \u00eenceperea administr\u0103rii acestora s\u0103 semnala\u0163i acest lucru medicului care a prescris anticoncep\u0163ionalele<\/p>\n<p>\u00een cazul \u00een care dori\u0163i s\u0103 ave\u0163i copii, iar acest lucru \u00eent\u00e2rzie de\u015fi nu folosi\u0163i nici un mijloc de contracep\u0163ie s\u0103 v\u0103 prezenta\u0163i (ambii parteneri) la medicul ginecolog \u015fi\/sau endocrinolog<\/p>\n<p>\u00een cazul \u00een care b\u0103iatul dumneavoastr\u0103 (sub 18 ani) prezint\u0103 brusc ginecomastie (m\u0103rirea s\u00e2nilor) \u015fi\/sau galactoree s\u0103 v\u0103 prezenta\u0163i la medicul pediatru \u015fi\/sau endocrinolog<\/p>\n<p>\u00een cazul unor dureri de cap (cefalee) care se repet\u0103 prea des \u015fi care \u00een general nu cedeaz\u0103 la antialgice obi\u015fnuite consulta\u0163i medicul de familie<\/p>\n<p>dac\u0103 vi se pare c\u0103 simptomele pe care le prezenta\u0163i seam\u0103n\u0103 cu cele descrise mai sus (dar nu ave\u0163i timp s\u0103 v\u0103 prezenta\u0163i la medic) \u015fi dori\u0163i s\u0103 v\u0103 determina\u0163i prolactina, o pute\u0163i face adres\u00e2ndu-v\u0103 laboratorului, urm\u00e2nd ca apoi rezultatele s\u0103 le prezenta\u0163i medicului endocrinolog<\/p>\n<\/div>\n            \n                    <\/div>\n                \n                \n    <\/div>\n<\/div><h2 class=\"has-text-color wp-block-heading\" style=\"color:#00539f\">Aten\u021bie<\/h2><p>Hiperprolactinemiile trebuie tratate chiar dac\u0103 sunt func\u0163ionale (excep\u0163ie face hiperprolactinemia din timpul sarcinii sau al\u0103pt\u0103rii). Tratamentul \u015fi durata tratamentului (3-6 luni) o stabile\u015fte medicul endocrinolog. Medicamentele utile \u00een acest caz (Bromcriptina, Dostinex, etc.) vor fi \u00eenso\u0163ite pe perioada administr\u0103rii de un mijloc de contracep\u0163ie pentru a evita o sarcin\u0103 (care ar impune oprirea administr\u0103rii tratamentului ceea ce nu este de dorit).<\/p><div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div><p><em>Dr. <strong>Liliana Lup<\/strong>,<br>Medic specialist laborator<br>Laborator Synevo Satu-Mare<\/em><\/p>","protected":false},"excerpt":{"rendered":"<p>Prolactina este un hormon sintetizat, depozitat \u015fi secretat de lobul anterior al hipofizei (gland\u0103 endocrin\u0103 situat\u0103 la baza creierului). Cercet\u0103rile au ar\u0103tat c\u0103 prolactina&#8230;<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[459],"tags":[],"class_list":["post-6956","post","type-post","status-publish","format-standard","hentry","category-sanatatea-prenatala"],"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/posts\/6956","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/comments?post=6956"}],"version-history":[{"count":17,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/posts\/6956\/revisions"}],"predecessor-version":[{"id":65254,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/posts\/6956\/revisions\/65254"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=6956"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/categories?post=6956"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/tags?post=6956"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}