Hyperprolactinaemia – Understanding Excess Prolactin

When dealing with hyperprolactinaemia, a condition where the hormone prolactin is abnormally high in the blood. Also known as high prolactin, it can affect both men and women and often signals an issue with the pituitary gland. The most common trigger is a benign growth called a prolactinoma, but certain medications, stress, and thyroid problems can also push prolactin levels up. Elevated prolactin interferes with the reproductive axis, so people often notice missed periods, unexplained milk flow, or reduced libido. In men, low testosterone and erectile difficulties may be the first clues.

Key Players Behind the Hormone Surge

The hormone at the center of this story is prolactin, a peptide hormone produced by the anterior pituitary that primarily stimulates milk production after childbirth. When prolactin climbs beyond normal limits, it sends a signal to the hypothalamus to shut down dopamine, the brain's natural brake on prolactin release. This feedback loop explains why dopamine‑boosting drugs are frontline therapy. The second major player is the prolactinoma, a typically non‑cancerous pituitary tumor that overproduces prolactin. Prolactinomas vary in size; micro‑adenomas are under 10 mm and often cause subtle symptoms, while macro‑adenomas can compress nearby structures, leading to headaches or vision changes. Recognizing these entities early helps prevent long‑term fertility problems and bone loss caused by chronic hormone imbalance.

Treatment hinges on restoring the dopamine‑prolactin balance. The most effective agents are dopamine agonists, medications like cabergoline and bromocriptine that mimic dopamine’s inhibitory effect on prolactin secretion. A typical regimen starts with a low dose that’s gradually increased until prolactin levels normalize and symptoms fade. Most patients see a rapid drop in prolactin within weeks, and tumor shrinkage often follows, reducing the need for surgery. Side effects are usually mild—nausea or light‑headedness—but regular monitoring ensures the dose stays optimal.

Beyond medication, lifestyle tweaks can support recovery. Managing stress, maintaining a healthy weight, and ensuring adequate vitamin D and calcium help protect bone health, which can suffer when estrogen drops due to high prolactin. For women trying to conceive, timing intercourse with ovulation tracking after prolactin normalizes improves chances of pregnancy dramatically. Men should discuss testosterone checks if low levels persist after prolactin control.

In short, hyperprolactinaemia weaves together a hormone, a pituitary tumor, and a dopamine‑based treatment pathway. Understanding how each element influences the others—prolactinoma raises prolactin, dopamine agonists lower it, and normalized levels restore reproductive function—gives you a clear roadmap. Below you’ll find articles that dig into breakthrough bleeding on hormonal birth control, affordable ways to buy essential meds, and detailed drug comparisons, all of which intersect with managing hormone‑related side effects and treatment choices.