Hyperprolactinemia Overview

Abnormal hormonal function affects both women and men

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Hyperprolactinemia is a state characterized by high levels of a hormone called prolactin in the blood. Prolactin is produced by the pituitary gland and plays a vital role in the development of the breasts during pregnancy.

While hyperprolactinemia is considered perfectly normal during pregnancy and breastfeeding, it can occur at other times due to disease and medication use. Hyperprolactinemia can affect both women and men, resulting in irregular menstrual periods and erectile dysfunction, among other things.

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Causes of Hyperprolactinemia

Prolactin levels may be elevated for any number of reasons. One of the more common causes is the formation of a benign tumor on the pituitary gland. This noncancerous growth, known as a prolactinoma, directly secretes excessive prolactin while decreasing the levels of other sex hormones.

Diseases affecting a portion of the brain called the hypothalamus can also cause hyperprolactinemia. The hypothalamus functions as the link between the nervous system and the pituitary gland. The increase in prolactin levels can often be directly linked to a tumor, trauma, or infection of the hypothalamus.

Other causes may include:

  • Hypothyroidism (low thyroid hormone levels)
  • Chronic kidney failure
  • Antidepressants
  • Antipsychotics
  • Antihypertensives
  • Anti-nausea medications
  • Estrogen
  • Stress, physical or psychological
  • Chest wall injury

Symptoms of Hyperprolactinemia

The symptoms of hyperprolactinemia in women can vary. When occurring outside of pregnancy or breastfeeding, they may include:

  • Infertility
  • Galactorrhea (abnormal lactation)
  • Infrequent or irregular periods
  • Amenorrhea (disappearance of periods)
  • Loss of libido
  • Breast pain

When occurring in men, the symptoms typically involve sexual dysfunction and/or pain associated with the formation of the prolactinoma. Common signs and symptoms include:

  • Erectile dysfunction
  • Gynecomastia (development of breast tissue)
  • Galactorrhea (abnormal lactation)
  • Infertility
  • Loss of libido

Because hyperprolactinemia in men does not always cause obvious symptoms, it is sometimes difficult to spot. In some cases, headaches caused by the pituitary tumor or changes in vision may be the first sign of the condition in both men and women.

Diagnosis of Hyperprolactinemia

The diagnosis of hyperprolactinemia involves a routine blood test to check prolactin levels. If the levels are elevated, the doctor may want to repeat the test, this time after you fast for at least eight hours.

Normal ranges for prolactin in your blood are:

  • Males: 2 to 18 nanograms per milliliter (ng/mL)
  • Non-pregnant females: 2 to 29 ng/mL
  • Pregnant females: 10 to 209 ng/mL

A magnetic resonance imaging (MRI) scan may be ordered to look for evidence of a pituitary growth or for damage to surrounding tissues. Blood tests to evaluate other hormone levels may be useful in ruling out any other possible causes of the symptoms.

Treatment of Hyperprolactinemia

The goal of treatment is to return prolactin to normal levels. There are a number of standard options to achieve this:

  • The medications Parlodel (bromocriptine) and Dostinex (cabergoline) are known to be effective in reducing prolactin levels and shrinking pituitary tumors.
  • Surgery may sometimes be used to remove a pituitary tumor if the medications are not working or are poorly tolerated.
  • Radiation, while rarely used, may be suggested if the medicines and surgery have not been effective.
  • Hypothyroidism can be treated with synthetic thyroid hormone, which should bring prolactin levels down.
  • If high prolactin levels are caused by prescription drugs, substitute medications may be prescribed.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Prolactinoma.

  2. Endocrine Society: Hormone Health Network. Hyperprolactinemia.

  3. American Society of Reproductive Medicine: ReproductiveFacts.org. Hyperprolactinemia (high prolactin levels).

  4. National Institute of Diabetes and Digestive and Kidney Diseases. Prolactinoma.

By Nicole Galan, RN
Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book."