Does High Prolactin Affect Fertility?
Prolactin is a hormone released by the pituitary gland in the brain, best known for driving milk production during breastfeeding. When it stays high outside that period, it can affect ovulation.
This article explains, for information, why prolactin rises, what symptoms it can cause, and how it relates to fertility.
What does prolactin do?
Prolactin's best known role is producing milk after birth. During that time high prolactin suppresses ovulation, creating a natural spacing between pregnancies.
Outside breastfeeding, a raised level can produce that same suppressing effect at an unwanted time.
Why does it rise?
There can be several reasons for a raised prolactin level:
- A small benign growth in the pituitary gland (prolactinoma)
- Certain medicines, particularly anti-sickness drugs and some psychiatric medicines
- An underactive thyroid (hypothyroidism)
- Significant stress or stimulation of the chest area
- Kidney or liver problems
Conditions immediately before the blood test can also influence the reading, which is why the test is usually repeated.
What are the symptoms?
Possible findings include:
- Infrequent periods or periods stopping
- Milky discharge from the breast when not pregnant
- Difficulty conceiving
- Headache or changes in vision, where a growth is present
- Reduced sexual desire
For background on cycle changes see ovulation and the fertile window.
How does it affect ovulation?
High prolactin can suppress the hormone signals travelling from the brain to the ovaries, so follicle development and ovulation may not proceed normally.
Periods can become infrequent or stop altogether, which makes conceiving more difficult.
How is it assessed?
Prolactin is measured with a blood test. Because the conditions of the test matter, it is usually repeated under suitable conditions.
Thyroid function is assessed alongside it, and where the level is markedly raised, imaging of the pituitary may be requested. See fertility testing for the wider work-up.
How is it treated?
Treatment depends on the cause. Where a medicine is responsible, it is reviewed together with the prescribing doctor. Where there is an underactive thyroid, that is treated first.
Where the cause lies in the pituitary, your doctor may plan appropriate medical treatment. As prolactin returns to normal, a regular ovulation pattern can be expected to resume, though response is individual.
Related Reading
- Ovulation Explained: When It Happens and How to Find Your Fertile Window
- Fertility Testing: How to Know If You Are Fertile (Female and Male)
- Unexplained Infertility: Meaning and Options
Sources and references
This article is supported by the following independent, authoritative sources: