In endometriosis, uterine tissue is found outside the uterus. Endometriosis is estrogen-dependent, occurs during the reproductive years and is progressive. The patients have pain, infertility and reduced natural killer (NK) cells in blood and peritoneal fluid. One-half of women with infertility have endometriosis.
This study was done to see whether stress could cause the changes seen with endometriosis. Stress inhibits NK cells. To determine stress levels, prolactin and cortisol were tested in blood, peritoneal fluid and follicular fluid in women without endometriosis and in women with endometriosis and infertility.
Forty-nine women were tested. Serum cortisol and prolactin were most elevated in infertile women with severe endometriosis. Serum prolactin and cortisol in women with mild endometriosis didn’t vary much from fertile women without endometriosis. Cortisol and prolactin did not vary much in peritoneal and follicular fluid.
The high levels of cortisol and prolactin seen in severe endometriosis could be related to infertility. High levels of cortisol and prolacatin seen in stress could cause development of endometriosis. High cortisol levels are seen in both physical and emotional stress. Prolactin can be released in stress.
Hyperprolactinemia (elevated blood prolactin,) or hyperprolactinaemia, is often seen in endometriosis, but, the frequency varies in current studies. This study showed prolactin blood levels correlated with disease severity. The authors did not find a significant correlation between follicular and peritoneal prolactin levels and disease.
CONCLUSION: High serum prolactin and cortisol are seen with endometriosis and stress. High serum prolactin is related to endometriosis, but, is not definitely the cause. It is unclear if elevated cortisol levels cause or are the result of endometriosis.
NOTE: Prolactin levels can be reduced by dopamine agonists, such as Vitex, tyrosine and phenylalanine and by 5-lipoxygenase inhibitors, such as Boswellia serrata. Studies are needed to see if they reduce endometriosis and infertility. Read about neovascularization in endometriosis.
To read the author’s abstract of the article click on the link to the author’s title of the article above.