Hyperprolactinemia
Hyperprolactinemia is a disorder in which the pituitary gland produces excessive amounts of the hormone prolactin, which stimulates milk production. Even when a person isn’t pregnant, a small amount of prolactin circulates in the blood. For people who are pregnant or just had a baby, a large amount of prolactin is found in the bloodstream.
Schedule an AppointmentWhat is hyperprolactinemia?
Hyperprolactinemia is an overabundance of the hormone prolactin. Sub-fertility as a result of this increased level can occur in both men and women, and is found in up to one-third of women experiencing amenorrhea. Prolactin is secreted by the pituitary gland and is used by the pregnant female body to prepare breasts for milk production. Galactorrhea, noticeable milk production from the breasts that occurs spontaneously during times other than when nursing, is often seen in patients with hyperprolactinemia.
What causes hyperprolactinemia?
In about 30 percent of patients the cause for hyperprolactinemia is unknown.
- Pituitary tumors, usually prolactinomas which are under 10 mm in diameter.
- Primary hypothyroidism.
- Ingestion of certain drugs, including phenothiazines, certain high blood pressure meds (especially a-methyldopa), tranquilizers and opioids, antinausea drugs, oral contraceptives.
- Chronic kidney failure and other medical conditions.
- Hyperprolatinamia is sometimes associated with hypogonadotropinism and hypogonadism.
Symptoms of hyperprolactinemia
Hyperprolactinemia symptoms vary. Common signs include:
- Irregular or absent menstrual periods.
- Headaches and visual difficulties.
- Lowered levels of LH and FSH.
- Increased levels of androgens.
- Galactorrhea: milk production when not pregnant.
If you experience these symptoms, consulting a fertility specialist can provide clarity and guidance.
How hyperprolactinemia affects fertility
Hyperprolactinemia, a condition characterized by elevated prolactin levels, can impact female fertility by disrupting normal reproductive hormone balance. The effects of hyperprolactinemia on fertility may include:
- Irregular or absent ovulation, making conception more difficult.
- Lower estrogen levels, which can affect egg quality and uterine lining development.
- Disruptions in menstrual cycles, leading to unpredictable fertility windows.
Unlike other fertility concerns, women with hyperprolactinemia don’t need to wait the usual 6-12 months to seek help. Consulting a fertility specialist early is essential to managing the condition and optimizing your fertility outcomes.
Diagnosing hyperprolactinemia
Hyperprolactinemia is diagnosed with blood tests to measure the following hormones:
- Basal prolactin level: usually first thing in the morning, before shower or exercise and eating.
- Thyroid test: A blood test that diagnoses thyroid disorders
- Computerized tomography (CT): A three-dimensional (3D) scan that produces an image of the pituitary gland to detect a tumor or other abnormality
- Magnetic resonance imaging (MRI): A scan that uses high-frequency radio waves to produce an image of the pituitary gland to detect a tumor or other abnormality
Fertility treatment options for hyperprolactinemia
Your treatment will depend on the cause of your excessive prolactin production. Once your prolactin blood level is within the normal range, your periods should become more regular and you should start ovulating normally again.
If your physician establishes a diagnosis of an underactive thyroid, he or she can prescribe thyroid medication for you. Once your thyroid problem is corrected, the amount of prolactin in your blood should decline to a normal level.
If you have a tumor on your pituitary gland, or the cause of your hyperprolactinemia is unknown, treatment with medication can reduce your prolactin levels. Also, the medication usually causes pituitary tumors to shrink. Although these medications are very effective in bringing down your prolactin level to a normal range, they cannot cure the disorder. If you stop treatment, your prolactin levels are likely to increase again, and your symptoms will probably return.
Our specialists will work closely with you to determine the best approach, combining medical expertise with compassionate care.
Take control of your fertility journey
Hyperprolactinemia doesn’t have to stand in the way of your dreams of parenthood. At RSC, we’re committed to helping you understand your condition, explore your options, and take confident steps forward.
