Hyperprolactinaemia

Key facts

• The pituitary gland releases more prolactin than the body needs. Prolactin normally triggers milk production after childbirth, but elevated levels at other times disrupt hormonal balance in both women and men.
• In women it suppresses oestrogen, causing irregular or absent periods, unexplained milky nipple discharge (galactorrhoea) and difficulty conceiving. In men it can lower testosterone, reduce libido and occasionally cause breast tissue changes.
• A prolactin-producing pituitary tumour (prolactinoma) can also press on nearby structures, causing headaches or visual disturbances in either sex.
• First-line treatment is a dopamine agonist: cabergoline, taken once or twice a week, or bromocriptine, an older alternative often preferred for women planning pregnancy.

What raised prolactin does

Prolactin's main job is triggering milk production after childbirth, so elevated levels outside that context throw other hormones off balance. In women, excess prolactin suppresses oestrogen, leading to irregular or absent periods, galactorrhoea (milky nipple discharge unrelated to breastfeeding) and difficulty conceiving. In men, it can reduce testosterone, lowering libido and occasionally causing breast tissue changes. Headaches or visual disturbances in either sex can point to a prolactin-producing pituitary tumour, called a prolactinoma, pressing on nearby structures.

How it's managed

Most cases respond well to dopamine agonists, which mimic the brain's natural prolactin-suppressing signals. Cabergoline is the most widely used option: taken just once or twice a week, it shrinks prolactinomas in the majority of patients. Bromocriptine is an older alternative that remains effective, particularly for women planning pregnancy. Both medicines sit within women's health and neurology care, given how closely pituitary function ties the two together. Regular follow-up with prolactin blood tests guides how long treatment continues.

When to see a doctor

See a doctor for irregular periods, unexplained nipple discharge, reduced libido or new headaches with visual changes, particularly if a fertility workup has stalled without explanation. Hyperprolactinaemia is a common and treatable cause of ovulatory problems.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.