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If your doctor has recommended a prolactin test, or if you're experiencing irregular cycles or unexplained infertility, understanding what this hormone does and how it impacts your ability to conceive is crucial.
It is important to discuss when and why prolactin testing is necessary, as well as what to expect if your levels are out of range.
What Is Prolactin and What Does It Do?
Prolactin is a hormone produced by the pituitary gland, which is tiny and situated at the base of the brain. Prolactin's name comes from Latin roots meaning "milk," signifying its primary function. It also plays a crucial role in managing the menstrual cycle and ovulation.When prolactin levels are normal, ovulation and conception usually occur without issue, but if prolactin levels are high (the condition is called hyperprolactinemia), it can result in disrupting hormone balances, suppressing ovulation, and making conception difficult.
Why Does Prolactin Matter When You're Trying to Conceive?
It’s natural to question how a hormone associated with pregnancy could play a role in fertility challenges. It depends on the sensitivity of reproductive hormones. Prolactin acts on the hypothalamic-pituitary-ovarian (HPO) axis, which controls menstrual cycles.High prolactin levels prevent the release of gonadotropin-releasing hormone (GnRH), which disrupts LH and FSH levels, the hormones responsible for triggering ovulation. Such interference may create:
- Irregular or missed periods
- Anovulation (lack of ovulation)
- Short luteal phases
- Low progesterone levels
- Difficulty conceiving
When Should You Get a Prolactin Test?
Your doctor may suggest a prolactin test if you are experiencing any of the following symptoms.:- Irregular menstrual cycles
- Absence of periods (amenorrhea)
- Galactorrhea (milky nipple discharge not related to breastfeeding)
- Infertility of unknown cause
- Frequent early pregnancy loss
- Symptoms of a pituitary disorder, such as vision problems or persistent headaches
Timing is also an important factor. Prolactin can fluctuate throughout the day, with high concentrations during sleep and early morning. For blood testing, samples are normally taken in the morning, preferably in a fasting state and ideally in the first half of the menstrual cycle (follicular phase).
What Causes High Prolactin Levels?
Several factors can cause higher prolactin levels. Some are temporary, and some can signal a medical condition.Physiological Causes (temporary or benign):
- Stress (physical or emotional)
- Lack of sleep
- Strenuous exercise
- Recent breast stimulation or intercourse
- Pregnancy or breastfeeding
Medical Causes:
- Prolactinoma (a benign tumour of the pituitary gland)
- Hypothyroidism
- Polycystic Ovary Syndrome (PCOS)
- Certain medications (antidepressants, antipsychotics, high blood pressure drugs)
- Chronic kidney or liver disease
How Is Prolactin Tested?
The prolactin test involves a simple blood draw, usually done in the morning when hormone levels are most accurate. Here’s what you can expect:- You'll be asked to fast overnight before your appointment.
- Avoid nipple stimulation and sexual activity 24 hours prior, as these can raise your prolactin levels.
- The blood is drawn and sent to a lab for analysis.
What Happens If Your Prolactin Levels Are High?
If your prolactin levels are elevated, don’t panic. This doesn’t necessarily mean a serious issue, but it warrants further understanding.Your doctor may order repeat testing to confirm the results and rule out temporary factors. If prolactin remains high, additional tests such as thyroid function tests, MRI scans of the pituitary gland, or a review of your medications may follow.
Treatment Options May Include:
- Addressing underlying causes (like correcting hypothyroidism)
- Discontinuing or adjusting medications that raise prolactin
- Dopamine agonists (e.g., cabergoline or bromocriptine), which lower prolactin production
- Surgical removal of a prolactinoma, in rare cases
Can You Conceive with High Prolactin Levels?
Conceiving with elevated prolactin is possible, but it depends on the underlying cause and how well it responds to treatment. Normalising prolactin levels leads to restored ovulation and regular cycles.If ovulation doesn’t return even after prolactin is corrected, your fertility specialist may consider ovulation induction medications or assisted reproductive techniques like intrauterine insemination (IUI) or in vitro fertilisation (IVF).
The key is identifying and addressing the issue early, giving you the best opportunity for a successful pregnancy.
What If Your Prolactin Levels Are Low?
While high prolactin levels are more commonly linked to fertility issues, low prolactin can also signal an underlying problem, particularly if it's related to pituitary gland dysfunction. Although it's not a frequent cause of infertility, it’s still something your doctor may explore if other symptoms are present.If experiencing irregular ovulation and unexplained infertility, Prolactin testing is life-altering. By catching and treating the cause behind high prolactin levels, you can correct hormonal balance, regain normal ovulation, and improve your conception chances dramatically.
In most cases, low prolactin isn’t the main barrier to conception. Still, it can be a clue to a broader hormonal imbalance that may need attention before moving forward with fertility treatment.
When you're trying to conceive, it’s easy to focus solely on ovulation predictor kits or cycle-tracking apps. But understanding the full picture of your hormonal health, including prolactin, can be a game-changer. By catching and treating the cause behind high prolactin levels, you can correct hormonal balance, regain normal ovulation, and improve your conception chances dramatically.
FAQs for Prolactin Testing in Women Trying to Conceive: When and Why
- How long after treating high prolactin can you get pregnant?
Most women resume ovulation within weeks of initiating treatment, particularly with drugs such as cabergoline or bromocriptine. Pregnancy can occur within a few months, depending on other fertility considerations. - Can stress increase prolactin levels?
Yes, both physical and emotional stress can temporarily increase prolactin. That’s why your doctor may recommend repeating the test if your first result is mildly elevated. - Do I need prolactin testing if I have regular cycles?
If your cycles and ovulation are normal, prolactin testing is usually not necessary.. If you have problems conceiving or experiencing other issues (like unexplained discharge or breast tenderness), your doctor will still order it to rule out underlying issues.
