Hyperprolactinemia is a condition caused by too much prolactin — the hormone that stimulates breast milk production. Because prolactin can interfere with ovulation, hyperprolactinemia can cause irregular periods. As a result, ovulation doesn’t occur every cycle, or the menstrual cycle becomes irregular.
Hyperprolactinemia can also cause headaches because it’s most often caused by a benign tumor in the pituitary gland, which is located just beneath the base of the brain. Some people with the condition also have nipple discharge.
If a patient comes in with those types of symptoms, then the first step is a blood test to see what their prolactin level is. It’s best to do this test first thing in the morning because they need to fast beforehand. It’s also important to avoid nipple stimulation prior to the test, because it can falsely signal elevated prolactin.
If hyperprolactinemia is confirmed, we check to make sure the test was done appropriately, and then I also screen them with an MRI to see if there is a tumor, and if there is one, to see how big it is.
Most of the time, if a tumor is found, it’s very small, so the recommendation is oral medications that help decrease the prolactin to restore ovulation.
I did have a patient with an elevated prolactin level. She had a very small tumor. And once we started the oral medication, she didn’t have to do anything. She was pregnant in two months.
So this was great because fertility treatments can be very expensive. Just correcting the underlying problem was enough for her to get pregnant naturally.