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Here is what you need to know about how hyperprolactinaemia may be affecting your fertility and what steps you can take to manage it.
What Is Prolactin, and Why Does It Matter?
Prolactin is a hormone produced by the pituitary gland at the base of the brain. Its primary function is to initiate lactation after childbirth. However, prolactin is always present in small amounts and also helps regulate immunity and metabolism.When you are not pregnant or breastfeeding, high prolactin levels can lead to reproductive issues by suppressing the gonadotropin-releasing hormone (GnRH). This, in turn, affects essential hormones like oestrogen, luteinising hormone (LH), and follicle-stimulating hormone (FSH). These hormones play a key role in ovulation and regular menstruation.
The sudden spike in prolactin levels may also cause your menstrual cycles to become irregular or stop altogether. Without regular ovulation, your chances of conceiving naturally decrease.
What Causes Hyperprolactinaemia?
Many factors can lead to hyperprolactinaemia; identifying the underlying cause is essential for its treatment. Common causes include:- Prolactinoma (Benign Pituitary Tumour): A small, non-cancerous tumour on the pituitary gland is one of the most common causes of elevated prolactin. These tumours have no visible symptoms but can significantly raise your prolactin levels.
- Medications: Certain medications, especially antipsychotics, antidepressants, blood pressure medicines, and anti-nausea drugs, may interfere with dopamine, a hormone that naturally inhibits prolactin levels.
- Hypothyroidism: When your thyroid is not functioning properly, your pituitary gland releases high levels of prolactin.
- Stress and nipple stimulation: Sometimes, you may experience a temporary spike in prolactin levels because of emotional stress, excessive exercise, or frequent nipple stimulation.
How Does Hyperprolactinaemia Affect Your Fertility?
High prolactin levels affect your fertility in many ways.- Ovulation: High prolactin interferes with GnRH, preventing the release of LH and FSH. Both are essential for maturing eggs in the follicle before their release.
- Low Oestrogen Levels: Oestrogen levels drop because of the absence of ovarian stimulation. This affects the endometrial lining and cervical mucus quality, both of which are important for conception.
- Irregular or Absent Periods: Your menstrual cycles may become irregular or disappear altogether, making it difficult to track ovulation accurately.
- Luteal Phase Defects: Even if ovulation occurs, high prolactin can affect the quality of the corpus luteum, reducing your body’s ability to support early pregnancy.
Symptoms to Watch Out For
You might not immediately suspect a hormone imbalance like hyperprolactinaemia, especially if your main concern is difficulty conceiving. However, several other signs may suggest high prolactin levels, such as:- Irregular or no periods
- Conception issues despite regular intercourse
- Breast discharge (galactorrhea), even if you are not breastfeeding
- Increased vaginal dryness due to low Oestrogen levels
- Headaches or vision changes
Diagnosing Hyperprolactinaemia
Your doctor may recommend a blood test to check your prolactin levels, which naturally fluctuate throughout the day. To get accurate results, you may need to take the test in the morning before eating.Additional tests your doctor may suggest include:.
- Thyroid function test (TSH and free T4)
- Rule out pregnancy
- Evaluate kidney and liver function
- Conduct an MRI scan to look for a prolactinoma
Treatment Options and Their Impact on Fertility
Please remember, hyperprolactinaemia is treatable. Treatment may also help restore normal prolactin levels in your body, leading to regular ovulation and improved fertility.1. Dopamine agonists: Your doctor might prescribe medications that mimic dopamine, which inhibit prolactin levels. These can also shrink prolactinomas (if present) and restore ovulation.
2. Treating underlying conditions: If hypothyroidism is the cause, thyroid hormone replacement therapy may help balance your prolactin levels.
3. Surgical or radiologic intervention: A large prolactinoma may not respond to medication. In such cases, your doctor might suggest surgery or radiation. However, this is uncommon and usually recommended for complex cases.
You can see improvement within a few months of starting the treatment. Your ovulation and menstrual cycle become regular, and you may be able to conceive naturally, without needing assisted reproductive technology.
Trying to Conceive with Hyperprolactinaemia: What to Expect
It can be quite stressful to be diagnosed with hyperprolactinaemia when you are trying to conceive. However, with the right care plan, conception is possible. This may involve:- Monitoring prolactin levels regularly to ensure they are within the normal range.
- Tracking your menstrual cycles to assess ovulation.
- Take prescribed medicines regularly, if your doctor prescribed dopamine agonists.
- Using fertility charting or ovulation kits to confirm ovulation after starting treatment.
Hyperprolactinaemia affects your fertility and can make it difficult to conceive. If you are experiencing unexpected lactation, irregular menstruation, or ovulation, it is worth consulting your doctor to check your prolactin levels.
Identifying the underlying cause and starting the correct treatment can bring your prolactin within the normal range, improving your chances of conceiving. Early medical intervention can make your fertility journey smooth.
FAQs on Hyperprolactinaemia and Its Effect on Fertility
- Can I still ovulate with high prolactin levels?
High prolactin levels suppress the hormones that cause ovulation, so you may ovulate, but the chances are low. However, after treatment, ovulation returns after prolactin levels reach normal levels. - How quickly can I conceive after treating hyperprolactinaemia?
Your ovulation may return within 6 to 12 weeks after starting your treatment. If you have no other fertility issues, you can conceive naturally within a few months. Your overall health will help you conceive faster. - Is it safe to take prolactin-lowering medications while trying to conceive?
Yes, you can take prescribed medicines by your doctor when you are trying to conceive with high prolactin levels. Your doctor may discontinue or suggest other medicines after you get pregnant based on your situation.
