Hyperprolactinaemia: What it is and what you can do

High prolactin levels (hyperprolactinaemia) are common and often treatable. Prolactin is a hormone made by the pituitary gland. When it’s too high you might notice missed periods, low sex drive, infertility, or milk production when you’re not pregnant. Sometimes there are no obvious symptoms — a blood test finds it.

Common causes and symptoms

Several things raise prolactin. The usual suspects are pituitary microadenomas (small benign tumours), some medications (antipsychotics, antidepressants, anti-nausea drugs), hypothyroidism, chest wall injury, and pregnancy. Symptoms differ by sex and age. Women often have irregular or stopped periods and milk discharge. Men may have low libido, erectile problems, or unexplained low energy. Headaches and blurred vision suggest a larger pituitary growth pressing nearby nerves.

Ask yourself: have you started new meds recently? Do you have unexplained milky discharge from the breast? Any persistent headaches or vision changes? These clues help your clinician decide the next test.

Testing, treatment, and everyday tips

If your GP suspects high prolactin, they’ll order a fasting morning blood test — prolactin is highest at night and after stress, so timing matters. If levels are high, the usual next step is an MRI of the pituitary to check for a tumour. Thyroid tests and a medication review are part of the workup, too.

Treatment depends on cause. If a medication is the trigger, your doctor may switch it. For pituitary tumours, first-line therapy is usually a dopamine agonist (like cabergoline or bromocriptine) which lowers prolactin and often shrinks the growth. Surgery is an option when drugs don’t work or when vision is threatened by a large tumour. If you want to get pregnant, your specialist will tailor treatment to preserve fertility while keeping you safe.

What can you do right now? Keep a list of your medications and share it. Note your menstrual pattern, sexual changes, and any breast discharge. If you have sudden vision loss, severe headache, or vomiting, go to emergency care — those are signs of a rapidly growing pituitary lesion.

Follow-up matters. If you start treatment, expect regular blood tests to check prolactin and periodic MRI scans for tumour size. Side effects from dopamine agonists can include nausea, dizziness, and tiredness — tell your doctor so they can adjust the plan. Fertility and pregnancy need extra planning, so involve an endocrinologist or a reproductive specialist early.

If you want, browse our related posts here for practical guides on medications, fertility and safe online pharmacies. Hyperprolactinaemia is usually manageable when you get the right tests and care — reach out to your provider and bring the questions you wrote down.