Last updated: March 24, 2022

Summarytoggle arrow icon

Hyperprolactinemia, which refers to the increased production of prolactin by the anterior pituitary, occurs physiologically during pregnancy, lactation, and periods of stress. Pathological hyperprolactinemia is most often the result of pituitary adenomas and less commonly due to primary hypothyroidism and/or dopamine antagonists (e.g., metoclopramide, haloperidol). Women with pathological hyperprolactinemia present with galactorrhea, loss of libido, infertility, menstrual dysfunction, and/or osteoporosis. Men generally present with loss of libido, erectile dysfunction, and/or gynecomastia. The diagnosis is confirmed by repeated measurement of early morning prolactin levels. After ruling out hypothyroidism, a cranial MRI should be performed to detect pituitary adenomas. Management consists of dopamine agonists (e.g., bromocriptine, cabergoline) and treating the underlying cause.

Epidemiologytoggle arrow icon

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

Hypothalamic dopamine inhibits prolactin, whereas thyrotropin-releasing hormone (TRH) stimulates prolactin release.

Pituitary adenomas are the most common cause (∼ 50%) of pathological hyperprolactinemia.

Pathophysiologytoggle arrow icon

Clinical featurestoggle arrow icon

Hormonal changes Clinical features of hyperprolactinemia [7][8]
Female Male
  • Loss of libido
  • Little to no noticeable effects

Patients with hyperprolactinemia due to a pituitary adenoma may also present with bitemporal hemianopsia and headache (see “Clinical features” in “Pituitary adenomas”)

Diagnosticstoggle arrow icon

Treatmenttoggle arrow icon

Referencestoggle arrow icon

  1. Johnson RE, Murad MH. Gynecomastia: pathophysiology, evaluation, and management. Mayo Clin Proc. 2009; 84 (11): p.1010-1015.doi: 10.1016/S0025-6196(11)60671-X . | Open in Read by QxMD
  2. Majumdar A, Mangal NS. Hyperprolactinemia. J Hum Reprod Sci. 2013; 6 (3): p.168-175.doi: 10.4103/0974-1208.121400 . | Open in Read by QxMD
  3. Le Moli R, Endert E, Fliers E, Prummel MF, Wiersinga WM. Evaluation of endocrine tests. A: the TRH test in patients with hyperprolactinaemia.. Neth J Med. 2003; 61 (2): p.44-8.
  4. Kruse A, Astrup J, Gyldensted C, Cold GE. Hyperprolactinaemia in patients with pituitary adenomas. The pituitary stalk compression syndrome.. Br J Neurosurg. 1995; 9 (4): p.453-7.doi: 10.1080/02688699550041089 . | Open in Read by QxMD
  5. Bahar A, Akha O, Kashi Z, Vesgari Z. Hyperprolactinemia in association with subclinical hypothyroidism. Caspian J Intern Med. . 2011; 2 (2): p.229–233.
  6. Torre DL, Falorni A. Pharmacological causes of hyperprolactinemia.. Therapeutics and clinical risk management. 2007; 3 (5): p.929-51.
  7. Meierkord H, Shorvon S, Lightman S, Trimble M. Comparison of the effects of frontal and temporal lobe partial seizures on prolactin levels.. Arch Neurol. 1992; 49 (3): p.225-30.doi: 10.1001/archneur.1992.00530270039016 . | Open in Read by QxMD
  8. Lusić I, Pintarić I, Hozo I, Boić L, Capkun V. Serum prolactin levels after seizure and syncopal attacks.. Seizure. 1999; 8 (4): p.218-22.doi: 10.1053/seiz.1999.0284 . | Open in Read by QxMD
  9. Bauer J. Epilepsy and prolactin in adults: a clinical review.. Epilepsy Res. 1996; 24 (1): p.1-7.doi: 10.1016/0920-1211(96)00009-5 . | Open in Read by QxMD

Icon of a lock3 free articles remaining

You have 3 free member-only articles left this month. Sign up and get unlimited access.
 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer