What You Need To Know about Your Prolactin Levels

Prolactin is a hormone made by your pituitary gland. Prolactin levels rise during pregnancy and postpartum. During pregnancy, prolactin causes your breasts to grow and produce mammary tissue in preparation for breastfeeding. When you breastfeed, it helps establish and maintain your milk supply. When you are done breastfeeding, your prolactin levels return to normal.

Other than during pregnancy and breastfeeding, prolactin levels should be low for everyone. Elevated prolactin levels outside of pregnancy and lactation may indicate a medical condition. They can cause symptoms such as menstrual irregularities, nipple discharge in non-breastfeeding people, infertility, and low sex drive.

Prolactin levels vary and rise naturally when a person is pregnant or lactating. Prolactin levels are highest during the REM phase of sleep (dreaming) and tend to peak between 4 am and 6 am. Prolactin is removed from the body by the kidneys and liver.

Here are normal prolactin levels in adults:

2-18 nanograms per milliliter (ng/mL) for males2-30 ng/mL for females

Prolactin levels are elevated during pregnancy and lactation. For example:

During the third trimester of pregnancy, prolactin levels can range from 10-210 ng/mL.
During lactation, prolactin levels can range from 13-345 ng/mL.

Hyperprolactinemia is a condition characterized by higher-than-normal prolactin levels. This condition can affect people in various ways and has numerous possible causes.

Causes

There are several different possible causes of hyperprolactinemia, including:

Prolactinoma (a benign tumor that grows on the pituitary gland, causing it to produce high levels of prolactin)
Medical conditions, such as hypothyroidism (underactive thyroid), kidney conditions and chest injuries
Nipple stimulation and orgasms during sex
Stress and trauma
Diets very high in protein
Certain medications, including the antipsychotic medications haloperidol and fluphenazine

Symptoms

Elevated prolactin levels can cause noticeable symptoms for many people, but the severity and type of symptoms experienced vary from person to person.

For people with female reproductive organs, hyperprolactinemia symptoms can include:

For people with male reproductive organs, hyperprolactinemia can cause the following symptoms:

Erectile dysfunction
Enlargement of breasts
Nipple discharge
Decreased libido (sex drive)
Less facial hair and body hair

Other possible symptoms of hyperprolactinemia include:

Effects

Elevated prolactin levels can affect your reproductive, sexual, and mental health, as well as your overall health and well-being. For example, hyperprolactinemia can cause:

Lactation and nipple discharge in non-lactating people
Menstrual cycle changes, including irregular periods and amenorrhea (lack of periods)
Erectile issues and decreased sexual drive

All of these effects can affect mental health, leading to symptoms of stress, depression, and anxiety.

Low prolactin levels are less common than elevated prolactin levels, but can occur.

Causes

Low prolactin levels are usually caused by a condition related to the pituitary gland. In particular, issues with your anterior (front lobe) pituitary gland can cause lower-than-normal prolactin levels.

One way that the pituitary gland can become damaged is through Sheehan syndrome. Sheehan syndrome occurs when someone loses a significant amount of blood during childbirth. This results in reduced blood and oxygen supply and damage to the pituitary gland. Lactating individuals may notice a low milk supply in the weeks after giving birth.

Symptoms and Effects

Low prolactin levels’ main effect is on lactation. Breastfeeding people will notice a low milk supply, typically the only apparent symptom of low prolactin levels.

Reach out to your healthcare provider if you have signs of elevated prolactin, such as nipple discharge, irregular periods, infertility, erectile dysfunction, and low libido. They will likely ask you about your overall health, your health history, and further details about your symptoms.

High prolactin is diagnosed by taking a blood sample to test your prolactin levels. This involves a healthcare provider drawing blood from a vein in your arm. It’s typically done about 3-4 hours after your daily wake-up time. Before the test, tell your provider about any medication you take.

If your blood test results show elevated prolactin levels, other tests may need to be conducted to determine the underlying cause. For example, magnetic resonance imaging (MRI) scans can determine if you have a benign pituitary tumor that may be causing your high prolactin levels.

The treatment plan for elevated prolactin depends on the cause. Medical interventions are not always necessary.

For instance, if a dietary issue or medication causes elevated prolactin levels, changing your diet or medication can help lower your levels. If your high prolactin levels are caused by stress, exercise, or excessive nipple stimulation, making changes in these areas can help.

Medical interventions are sometimes required for hyperprolactinemia. Here are some possible options:

If you have hypothyroidism, thyroid replacement therapy can help stabilize your prolactin levels.
Non-cancerous tumors of the pituitary gland (prolactinomas) are usually treated with dopamine agonist medications, either cabergoline or bromocriptine.
If medications do not shrink a pituitary tumor, surgery is considered. In rare cases, radiation therapy may be used.

Prolactin levels rise during pregnancy and breastfeeding. At other times, elevated prolactin levels, known as hyperprolactinemia, might indicate an underlying condition.

Elevated prolactin levels can be triggered by factors like non-cancerous tumors on your pituitary gland, thyroid issues, or medications. It may cause symptoms like nipple discharge and erectile function and affect menstrual cycles, fertility, and sex drive.

Consult a healthcare provider if you are concerned about your symptoms or if you suspect you may have high prolactin.