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Can Hyperprolactinemia Cause Infertility?

Written By Samyukta Nagabhushana - December 19, 2024

Read Time - 5 Min

Have you noticed a milky nipple discharge even though you’re not pregnant? Then you could be suffering from hyperprolactinemia—a condition caused by an increase in prolactin hormone in the blood. It’s a rare disorder, affecting females more often than men, And though not life-threatening, it may lead to complications such as infertility.¹ So, it’s important to understand its cause, identify the symptoms and start the course of treatment as soon as possible.

This blog will give you a comprehensive understanding of the disorder, and also provide valuable tips to help manage the condition. Keep reading!

What Is Hyperprolactinemia?

Hyperprolactinemia is a hormonal disorder that can affect men as well as women. But it is more common in women. It is characterised by abnormally high levels of the hormone prolactin in your blood.¹

What Is Prolactin?

Prolactin is a hormone secreted mainly by the pituitary gland. But the hormone can also be secreted by other body parts & systems such as:¹

Central nervous system
Uterus
Mammary glands
Immune system

Prolactin is responsible for several functions in the body including:²

Lactation
Metabolism
Mammary gland development
Immune response

Who Does Hyperprolactinemia Affect?

People under the age of 40 are more likely to be affected by hyperprolactinemia. It’s more common in women affecting up to 17% of those with PCOD (Polycystic Ovarian Disease). The condition is not quite common in men and rare among children. ²

What Is The Difference Between Hyperprolactinemia And Prolactinoma?

Hyperprolactinemia may be caused due to several factors, prolactinoma being the most common one. Prolactinoma is a non-cancerous tumour of the pituitary gland. So while both these conditions are marked by an increase in prolactin levels, the latter is just one of the causes of hyperprolactinemia.

Hyperprolactinemia Causes

As mentioned earlier, there could be several possible causes for hyperprolactinemia. A few of them include:¹

Prolactinoma (the most common one).
Certain medications like antipsychotics, antidepressants, opiates and cocaine, antihypertensive medications, gastrointestinal medications, estrogens, etc.
Certain health conditions like chronic kidney disease, hypothyroidism, shingles (a painful viral rash), chest wall injuries, polycystic ovary syndrome (PCOS), Cushing’s syndrome, Nelson syndrome, etc.
Other tumours of the pituitary gland.
Radiation treatment to the pituitary or its nearby region.

At times, the cause of hyperprolactinemia remains unknown. This is called idiopathic hyperprolactinemia which resolves on its own after some time (a few months).

Hyperprolactinemia Symptoms

Sometimes people with hyperprolactinemia may have very mild or no symptoms at all. But in general its common symptoms include:¹

Milky discharge from your nipples
Infertility
Loss of sexual desire
Low bone mass

Its gender-specific symptoms include:¹

For women:

Menstrual irregularity or no periods at all
Vaginal dryness causing pain during intercourse

For men:

Erectile dysfunction
Low testosterone levels
Enlarged breasts

Moreover, if hyperprolactinemia is caused by a prolactinoma, you may notice some additional signs such as:¹

Headaches
Nausea
Vomiting
Changes in vision (double vision or decreased peripheral vision)
Pain or pressure in the sinus
Problems with your sense of smell

Complications Of A Prolactinoma—The Most Common Cause Of Hyperprolactinemia

A prolactinoma may give rise to certain complications such as:⁶

Infertility: Too much prolactin interferes with the normal production of male & female sex hormones namely progesterone & estrogen. In females, it prevents the release of an egg while in males it hampers sperm production.
Bone loss: Osteoporosis or bone loss is another complication of prolactinoma. The lag in estrogen production can cause weak brittle bones that break easily.
Pregnancy complications: Hyperprolactinemia during pregnancy can increase your estrogen levels, which in turn can enlarge the size of the prolactinoma tumours, leading to headaches, vision loss and other symptoms.
Vision loss: Your optic nerve is responsible for sending the signals of vision from your eyes to the brain, helping you see. But a prolactinoma that presses on this optic nerve can cause impaired vision, its first sign being a loss of peripheral vision.
Low levels of other pituitary gland hormones: A large prolactinoma can also put pressure on the healthy parts of your pituitary gland—leading to a negative impact on the production of other hormones secreted by this gland, namely thyroid and cortisol.

How Is Hyperprolactinemia Diagnosed?

Are you experiencing any of the symptoms that we mentioned in the last section? Then chances are, your doctor might ask you to go for a prolactin blood test—the diagnostic test for hyperprolactinemia.¹

An ideal choice for women suspecting hyperprolactinemia could be LifeCell’s OvaScore—an at-home, diagnostic test of 9 female fertility hormones, including prolactin. The test will not just detect your hormone levels but also identify potential problems with your reproductive health and fertility. This should be particularly helpful for women who are trying to conceive.

Hyperprolactinemia Treatment

If you have hyperprolactinemia with few or no symptoms, you probably won’t need treatment. But for those of you who do, the treatment will depend on the underlying cause of your disorder.

So if it’s a prolactinoma, the treatment would include:¹

Medication: The most common treatment for prolactinoma are medications called dopamine agonists. They effectively shrink these tumours and bring down prolactin levels.
Surgery: This is the next line of treatment for prolactinoma when the medicines don’t work.
Radiation Therapy: If either of the first two options doesn’t work, a rare third option used to treat prolactinoma is radiation therapy.

Moreover, if a low thyroid level (hypothyroidism) is the culprit behind your condition, the doctor might treat you with synthetic thyroid hormone.

And if it's your medicines that are raising your prolactin levels, the doctor might prescribe some alternatives.

Summing Up

While hyperprolactinemia is not a life-threatening condition, it’s important to promptly address the issue, especially for women who are planning for pregnancy. The right treatment can not only help restore ovulation but also improve their overall fertility.

FAQs

1. What Is The Main Cause Of Hyperprolactinemia?

The main cause of hyperprolactinemia is an increase in the level of the hormone prolactin. This is often a result of prolactinoma, a non-cancerous tumour.