Prolactin is a hormone made by the pituitary gland. Its job is to prepare the breasts for breastfeeding during and after pregnancy. When prolactin rises outside pregnancy and breastfeeding (hyperprolactinemia), it disturbs the release of FSH and LH from the pituitary, leading to irregular or absent ovulation and periods, and difficulty conceiving. It may also cause a milky discharge from the breasts.
Causes include stress, pituitary disorders and small benign pituitary tumours (prolactinomas). An underactive thyroid can also raise prolactin, as can some medications, including certain blood pressure drugs, antipsychotics, antidepressants and anti-sickness medicines.
Testing prolactin
Prolactin can be measured on any day of the cycle, ideally in the morning and without significant stress beforehand, as stress and even the blood draw itself can raise it slightly. A mildly raised result should be repeated, and thyroid function checked. If prolactin is confirmed high, an MRI of the pituitary is used to detect or exclude a small tumour.
Treatment
Medication
Medication is the first-line treatment and usually restores normal prolactin levels and ovulation. Cabergoline, taken once or twice a week, is now preferred because it is more effective and causes fewer side effects. Bromocriptine, taken daily, is an older alternative that more often causes nausea and vomiting.
Surgery
Surgery is reserved for pituitary tumours that do not respond to or cannot tolerate medication, or larger tumours pressing on surrounding structures such as the optic nerves.
Radiotherapy
Radiotherapy is rarely needed, and only when both medication and surgery have failed.
International Guidelines
In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.
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Why Choose Dr. Ashraf Sabry?
Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.