Published: 18 Jun 2025

ICD9: 253.1      ICD10: E22.9      ICD11: 5A60.1

Hyperprolactinemia is a condition in which a person has higher-than-normal levels of the hormone prolactin in the blood.


Here's a breakdown of what that means and why it matters:

Prolactin: This is a hormone primarily produced by the pituitary gland, a small gland at the base of the brain. Its main function is to stimulate milk production (lactation) in pregnant and postpartum women. It also plays a role in sexual function and reproduction.

Hyper-: Means "above" or "excessive".

-emia: Means "in the blood".

Causes of Hyperprolactinemia:

Hyperprolactinemia can be caused by a variety of factors, including:

Prolactinomas: These are non-cancerous tumors of the pituitary gland that produce excess prolactin. This is the most common cause.
Certain Medications: Some medications, especially antipsychotics, antidepressants, and certain blood pressure medications, can increase prolactin levels.
Other Pituitary Tumors or Conditions: Tumors near the pituitary gland can sometimes interfere with its function and lead to increased prolactin production.
Hypothyroidism: An underactive thyroid gland can sometimes cause elevated prolactin levels.
Kidney Disease: Chronic kidney disease can affect prolactin clearance from the body.
Liver Disease: Similar to kidney disease, liver disease can impair prolactin processing.
Stress: Physical or emotional stress can sometimes lead to temporary increases in prolactin.
Nipple Stimulation: Frequent or prolonged nipple stimulation can increase prolactin levels.
Chest Wall Injuries or Surgery: Trauma to the chest wall can sometimes stimulate prolactin release.
Idiopathic Hyperprolactinemia: In some cases, the cause of hyperprolactinemia is unknown (idiopathic).

Symptoms of Hyperprolactinemia:

Symptoms can vary depending on the cause and severity of the condition.

In Women:

Irregular or absent menstrual periods (amenorrhea)
Difficulty getting pregnant (infertility)
Galactorrhea: Production of breast milk when not pregnant or breastfeeding
Decreased libido (sex drive)
Vaginal dryness
Headaches
Vision problems (if caused by a large pituitary tumor)

In Men:

Decreased libido (sex drive)
Erectile dysfunction
Gynecomastia: Enlargement of breast tissue
Infertility
Headaches
Vision problems (if caused by a large pituitary tumor)
Galactorrhea (rare)

Diagnosis:

Hyperprolactinemia is usually diagnosed through a blood test to measure prolactin levels. If levels are elevated, further testing may be done to determine the underlying cause, such as:

Repeat prolactin tests
Thyroid function tests
Kidney and liver function tests
MRI of the pituitary gland

Treatment:

Treatment depends on the cause of the hyperprolactinemia:

Medication: Dopamine agonists (e.g., bromocriptine, cabergoline) are commonly used to lower prolactin levels. These medications can also shrink prolactinomas.
Surgery: In some cases, surgery may be necessary to remove a pituitary tumor.
Radiation Therapy: Rarely used, but may be an option if medication and surgery are not effective.
Observation: If the hyperprolactinemia is mild and not causing significant symptoms, a doctor may recommend monitoring the condition without treatment.
Addressing the Underlying Cause: If the hyperprolactinemia is caused by medication or another medical condition, addressing that underlying cause may help to lower prolactin levels.

When to See a Doctor:

If you are experiencing any of the symptoms of hyperprolactinemia, it's important to see a doctor for evaluation and diagnosis. Early diagnosis and treatment can help to prevent complications and improve quality of life.

In summary, Hyperprolactinemia is a condition of having abnormally high levels of prolactin in the blood, which can cause a variety of reproductive and other health problems in both men and women. It is important to seek medical advice for proper diagnosis and management.