High prolactin in women is a hormonal condition that can affect menstrual periods, ovulation, fertility, and overall reproductive health. Prolactin is an important hormone produced by the pituitary gland and is naturally elevated during pregnancy and breastfeeding.
However, when prolactin levels are high when a woman is not pregnant or breastfeeding, it may require further evaluation to understand the underlying cause.
In this article, we explain the symptoms of high prolactin, causes of elevated prolactin, its effect on fertility, diagnosis, and treatment options.
What Is Prolactin?
Prolactin is a hormone produced by the pituitary gland, a small gland located at the base of the brain.
The hormone is primarily associated with breast development and milk production. Prolactin also interacts with other reproductive hormones and can influence ovulation and menstrual cycles.
During pregnancy and breastfeeding, increased prolactin levels are normal.
When prolactin becomes elevated outside these situations, doctors may refer to the condition as hyperprolactinemia.
What Does High Prolactin Mean?
High prolactin, or hyperprolactinemia, means that the amount of prolactin measured in the blood is higher than the expected range for that particular situation.
A prolactin result should always be interpreted according to the laboratory’s reference range and the individual’s circumstances.
Pregnancy, breastfeeding, certain medications, stress, thyroid disorders, and some pituitary conditions can all influence prolactin levels.
Therefore, one abnormal prolactin test does not necessarily identify the cause by itself.
Symptoms of High Prolactin in Women
Some women with high prolactin may have no noticeable symptoms. Others may experience changes in their menstrual or reproductive health.
Common high prolactin symptoms can include:
- Irregular periods
- Missed periods
- Difficulty becoming pregnant
- Changes in ovulation
- Unexpected milk-like discharge from the breasts
- Breast tenderness
- Reduced sexual desire
- Vaginal dryness
- Headaches in some cases
- Vision changes in certain pituitary conditions
The symptoms can vary depending on how high the prolactin level is and what is causing the elevation.
What Causes High Prolactin Levels?
There are several possible causes of high prolactin.
Pregnancy and Breastfeeding
Prolactin naturally rises during pregnancy and breastfeeding. This increase is part of the body’s normal preparation for and support of milk production.
Medications
Certain medicines can increase prolactin levels. If you are taking medication and receive an abnormal prolactin result, tell your doctor about all prescription medicines, over-the-counter medicines, and supplements you are using.
Do not stop prescribed medication without medical advice.
Thyroid Disorders
Certain thyroid problems can be associated with elevated prolactin. Your doctor may therefore recommend thyroid testing as part of the evaluation.
Pituitary Conditions
Because prolactin is produced by the pituitary gland, conditions affecting this gland can sometimes cause elevated prolactin.
One example is a prolactinoma, a usually benign pituitary tumor that produces excess prolactin.
Importantly, having high prolactin does not automatically mean you have a prolactinoma. Further evaluation is needed to determine the cause.
Temporary Hormonal Changes
Prolactin can also change temporarily due to factors such as physical or emotional stress and other physiological influences.
Your doctor may consider these factors when interpreting your test result.
Can High Prolactin Affect Menstrual Periods?
Yes. One of the effects of elevated prolactin can be disruption of the hormonal signals involved in ovulation.
As a result, some women may experience:
- Longer or shorter menstrual cycles
- Irregular periods
- Very light periods
- Missed periods
- Absence of periods
If your menstrual cycle has changed unexpectedly, a gynecological evaluation can help determine the underlying cause.
High Prolactin and Fertility
One of the most common concerns surrounding elevated prolactin is fertility.
High prolactin can interfere with the hormones involved in ovulation. If ovulation becomes irregular or does not occur, becoming pregnant may become more difficult.
However, high prolactin is only one possible factor affecting fertility.
When evaluating fertility, doctors may also assess other hormones, ovarian function, thyroid function, age, reproductive history, and the male partner’s fertility when appropriate.
If you are trying to conceive and have an elevated prolactin level, discussing the result with a gynecologist or fertility specialist can help determine the next steps.
Can High Prolactin Cause Breast Milk Discharge?
Yes. Some women with elevated prolactin may experience milky breast discharge even when they are not pregnant or breastfeeding.
This symptom is sometimes called galactorrhea.
However, breast discharge can have different causes, so it is important to discuss unexpected discharge with a healthcare professional rather than assuming it is caused by
