Hyperprolactinemia Quiz
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I have trouble with my period
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Producing breast milk inappropriately
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What is Hyperprolactinemia?
Excessively high prolactin (hormone that releases milk) levels in the blood. Causes include medications and brain tumors.
Typical Symptoms of Hyperprolactinemia
- Enlarged male breast tissue
- Inappropriate milk production e.g. not pregnant or with recent childbirth, or as a male
- Difficulty achieving or maintaining an erection
- Headache
- Hair loss
- History of underactive thyroid / low thyroid levels
- Nipple rash, redness, discharge, pain or itch
- Taking psychiatric medications or sleeping pills
Diagnostic Questions for Hyperprolactinemia
Your doctor may ask these questions to check for this disease:
- Have you noticed an unusual increase in your breast size?
- Are you producing breast milk without being pregnant or giving birth, or if you are a man?
- Are you worried about your sexual performance because you can't get or keep an erection for sex?
- Do you have a headache?
- Are you experiencing increased hair loss?
Treatment of Hyperprolactinemia
Treatment focuses on lowering prolactin levels back to normal. This is typically done with medications. In some cases, surgery or radiation may be required to remove a tumor.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Hidetaka Hamasaki, MD (Endocrinology)
Dr. Hamasaki graduated from the Hiroshima University School of Medicine and the Graduate School of Medicine, Jichi Medical University. He completed his residency at the Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Hospital and the Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine. He has served in the National Center for Global Health and Medicine Hospital and Kohnodai Hospital and joined Hamasaki Clinic in April 2017. Dr. Hamasaki specializes in diabetes and treats a wide range of internal medicine and endocrine disorders.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Swollen male breast
- Producing breast milk but not pregnant
- Enlarged breasts in men
- Premature ejaculation
- Inappropriate breast milk production
- Impotence
- Leaking breast before positive pregnancy test
- Pulsating headache
- Delayed ejaculation
- White secretion from nipple
- Headache on the side of my head
- Low libido
- Headache over the entire head
- No sex drive
- Losing erection with new partner
See full list
Symptoms Related to Hyperprolactinemia
Diseases Related to Hyperprolactinemia
FAQs
Q.
Strange Symptoms? Why Your Prolactin Is Rising & Your Medical Next Steps
A.
Elevated prolactin is often due to pregnancy or breastfeeding, stress, common medications, hypothyroidism, or a benign pituitary tumor, and can lead to missed periods, breast discharge, low libido, headaches, or vision changes. There are several factors to consider; see below to understand more. Typical next steps include repeating a morning level while calm and fasting, reviewing medications, checking thyroid labs, and getting a pituitary MRI if needed, with treatments ranging from correcting thyroid levels or adjusting meds to dopamine agonists for prolactinomas, and urgent care is warranted for severe headaches or vision loss. Important nuances that could change your plan are covered below.
References:
* Colao A. Hyperprolactinemia: An Update on Differential Diagnosis and Management. J Clin Endocrinol Metab. 2020 Feb 1;105(2):e267-e279. doi: 10.1210/jcem.2019-01472. PMID: 31696229.
* Chahal J, Sahota AK, Nieman LK. Prolactinomas: Diagnosis and Management. In: Feingold KR, Anawalt B, Blackman I, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. 2020 Jan 25. PMID: 27122176.
* La Torre D, Falorni A. Drug-induced hyperprolactinemia: from diagnosis to management. J Endocrinol Invest. 2020 Dec;43(12):1733-1748. doi: 10.1007/s40618-020-01222-w. Epub 2020 Apr 24. PMID: 32333146.
* Melmed S, Casanueva FF, Hoffman AR, Kleinberg SJ, Montori VM, Schlechte JM, Wass JA; Endocrine Society. Diagnosis and Management of Hyperprolactinemia: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011 Feb;96(2):273-288. doi: 10.1210/jc.2010-1692. Epub 2011 Jan 26. PMID: 21290991.
* Cikma SM, Kadioglu P, Cikma O. The Many Faces of Hyperprolactinemia. J Clin Res Pediatr Endocrinol. 2022 Jul 1;14(Suppl 1):17-25. doi: 10.4274/jcrpe.galenos.2022.2022.007. PMID: 35920367; PMCID: PMC9360533.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, Wass JA; Endocrine Society. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Feb;96(2):273-88. doi: 10.1210/jc.2010-1692. PMID: 21296991.
https://academic.oup.com/jcem/article/96/2/273/2709487Capozzi A, Scambia G, Pontecorvi A, Lello S. Hyperprolactinemia: pathophysiology and therapeutic approach. Gynecol Endocrinol. 2015 Jul;31(7):506-10. doi: 10.3109/09513590.2015.1017810. Epub 2015 Jul 6. PMID: 26291795.
https://www.tandfonline.com/doi/full/10.3109/09513590.2015.1017810Vilar L, Vilar CF, Lyra R, Freitas MDC. Pitfalls in the Diagnostic Evaluation of Hyperprolactinemia. Neuroendocrinology. 2019;109(1):7-19. doi: 10.1159/000499694. Epub 2019 Mar 20. PMID: 30889571.
https://www.karger.com/Article/FullText/499694Chahal J, Schlechte J. Hyperprolactinemia. Pituitary. 2008;11(2):141-6. doi: 10.1007/s11102-008-0107-5. PMID: 18404389.
https://link.springer.com/article/10.1007/s11102-008-0107-5Matalliotakis M, Koliarakis I, Matalliotaki C, Trivli A, Hatzidaki E. Clinical manifestations, evaluation and management of hyperprolactinemia in adolescent and young girls: a brief review. Acta Biomed. 2019 Jan 23;90(1):149-157. doi: 10.23750/abm.v90i1.8142. PMID: 30889169; PMCID: PMC6502148.
https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/8142Hyperprolactinemia - Johns Hopkins Medicine
https://www.hopkinsmedicine.org/health/conditions-and-diseases/hyperprolactinemia#:~:text=Hyperprolactinemia%20is%20marked%20by%20abnormally,controls%20production%20of%20this%20hormone.