Hyperprolactinaemia: what it is and what you can do

High prolactin levels (hyperprolactinaemia) are a common reason people see an endocrinologist. Prolactin is a hormone made in the pituitary gland that helps with milk production and affects sex hormones. When levels stay too high you can notice changes in periods, sexual function, fertility and sometimes vision or headaches. The good news: most causes are treatable, and many people get back to normal with straightforward care.

Causes and common signs

Wondering what raises prolactin? Common causes include a small pituitary tumor (prolactinoma), certain medications (antipsychotics like risperidone, some anti-nausea drugs such as metoclopramide, and some antidepressants), low thyroid function, and pregnancy. Less often, chest wall injury, chronic stress, or other pituitary problems are responsible.

Signs depend on sex and age. Women may have irregular or missed periods, milky nipple discharge, or trouble getting pregnant. Men can notice low libido, erectile problems, or infertility. A large pituitary tumor can press on nearby nerves and cause headaches or loss of side vision. If you spot any of these, get checked — simple tests can find out what’s going on.

Testing, treatment and what to expect

Diagnosis starts with a blood test for prolactin. Your doctor often checks thyroid function and will rule out pregnancy. If prolactin is clearly high, an MRI of the pituitary gland is usually the next step to look for a tumor and measure its size.

Treatment aims to lower prolactin, shrink any tumour, and restore normal hormone function. First-line medicines are dopamine agonists — cabergoline is commonly used because it works well and has fewer daily side effects than older options. Bromocriptine is another choice, and both are available as generics in many countries, which often cuts cost. Side effects can include nausea, dizziness, or sleepiness; most people tolerate treatment after a short time. Surgery is reserved for large tumours that press on the optic nerves or when medication fails.

If you’re trying to conceive, lowering prolactin often restores ovulation and improves fertility. During pregnancy small prolactinomas usually don’t need treatment, but larger ones may require closer monitoring or continued medication under specialist advice.

Practical tips: tell your doctor about all meds you take — switching or stopping an offending drug can fix prolactin in some cases. Ask about generic cabergoline prices and compare local pharmacies or online options to save money. Keep a record of symptoms and menstrual cycles; that helps your clinician judge progress. And if you experience vision changes or severe headaches, seek urgent care — those signs need quick action.

Hyperprolactinaemia sounds scary but is often manageable. Get tested, ask for clear explanations, and work with a specialist if needed. Small changes in treatment or meds usually bring big improvements in symptoms and quality of life.