Fertility & Pregnancy - Bloody Good
Hormone

Prolactin

The Prolactin Test measures levels of prolactin, a hormone made by the pituitary gland. Prolactin is important for fertility, sexual health, and milk production in women. Abnormal levels may suggest hormone imbalances that affect periods, fertility, or sexual function. In some cases, very high prolactin can be linked to growths in the pituitary gland (usually benign), so this test may help guide whether further checks are needed.

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Prolactin

Experiencing irregular periods, fertility challenges, unexpected breast milk production, or sexual dysfunction that could be related to prolactin imbalance?

Overview

Think of prolactin as your body's nurturing hormone – while it's famous for triggering milk production in new mothers, this clever chemical messenger actually works behind the scenes throughout your entire life to keep your reproductive system running smoothly. Your pituitary gland releases just the right amount of prolactin to support everything from your immune system to your metabolism, but like a thermostat that gets stuck, sometimes those levels can go haywire and throw your whole system off balance.

When prolactin levels climb too high outside of pregnancy and breastfeeding, it's like having an overprotective parent who won't let the other hormones do their jobs – it can shut down ovulation in women, leading to missed periods and fertility struggles, or dial down testosterone in men, causing issues with libido and sexual function. Since elevated prolactin can stem from various sources like stress, certain medications, thyroid problems, or small pituitary growths, testing your levels becomes especially valuable if you're dealing with unexplained fertility issues, irregular cycles, unexpected breast milk production, or changes in sexual health that just don't seem to have an obvious cause.

Reviewed by Dr. Vu Tran
Bloody Good’s Chief Medical Officer

Symptoms

You may benefit from this test if you experience:
Irregular periods (cycles shorter than 21 or longer than 35 days) Breast discharge when not breastfeeding Low sex drive in men Low sex drive in women Missed periods (not due to pregnancy)

Purpose

Essential for women with irregular menstruation, fertility problems, or galactorrhea (inappropriate milk production). Important for men with erectile dysfunction, decreased libido, or suspected pituitary disorders. Valuable for investigating reproductive hormone imbalances and monitoring pituitary function.

How to prepare

Best tested in the morning (9-11 AM) when levels are most stable. Avoid testing immediately after breast examination, sexual activity, or exercise as these can temporarily elevate prolactin. No fasting required. Stress can affect results, so try to be relaxed during blood collection. Inform your healthcare provider about all medications, especially those affecting dopamine.

Understanding results

Normal ranges vary by gender and physiological state. Non-pregnant women: 2-25 ng/mL (4-530 mIU/L); Men: 2-15 ng/mL (4-320 mIU/L); Pregnant women: up to 300 ng/mL; Breastfeeding women: up to 250 ng/mL. Levels above 25 ng/mL in non-pregnant women or 15 ng/mL in men may indicate prolactin excess requiring further evaluation.

After the test

Discuss elevated results with an endocrinologist or reproductive specialist. Further testing may include MRI of the pituitary gland, thyroid function tests, or medication review. Treatment depends on the underlying cause and may include dopamine agonist medications for prolactinomas or addressing underlying medical conditions. Regular monitoring may be required.

Frequently Asked Questions

  • Common causes include pregnancy, breastfeeding, stress, certain medications (antidepressants, antipsychotics), hypothyroidism, kidney disease, chest wall injuries, and pituitary tumors called prolactinomas.
  • Yes, many medications can raise prolactin, including some antidepressants, antipsychotics, blood pressure medications, anti-nausea drugs, and opioids. Always inform your doctor about all medications before testing.
  • A prolactinoma is a benign tumor of the pituitary gland that produces excess prolactin. Most are small (microprolactinomas) and respond well to medication. Large ones (macroprolactinomas) may cause headaches and vision problems.
  • Elevated prolactin suppresses LH and FSH production, which can prevent ovulation in women and reduce testosterone in men, leading to fertility problems in both genders.
  • Yes, physical and emotional stress can significantly elevate prolactin levels. This is why the test should be done when you're as relaxed as possible, preferably in the morning.
  • This depends on the underlying cause. Medication-induced elevation usually reverses when the drug is stopped. Prolactinomas often respond well to dopamine agonist medications, normalizing prolactin levels in most cases.
Prolactin

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