Symptoms of high prolactin (hyperprolactinemia) include irregular periods or no periods, premenstrual mood symptoms, loss of libido, headaches, breast pain, vaginal dryness, acne, and hirsutism or facial hair.
High prolactin is one of several causes of androgen excess and can be mistaken for polycystic ovary syndrome or PCOS.
How to diagnose high prolactin
In a non-lactating woman, prolactin should b less than 500 mIU/L or 23 ng/mL (and ideally less than 300 mIU/L or 14 ng/mL).
If your prolactin tests high, first consider if it could be temporarily or falsely elevated due to stress, exercise, or eating. To obtain an accurate reading, try to have a prolactin test under the following conditions:
- early in the follicular phase of the menstrual cycle
- between 8 a.m. and 12 p.m.
- not directly after exercise or sex
- relaxed, and
- not on hormonal birth control.
If your prolactin is elevated on at least two occasions, the next step is to identify the underlying cause with the help of your doctor. Common causes include:
- prolactinoma, which is a benign pituitary tumour
- high estrogen, either endogenous or from the pill
- medications such as SSRI antidepressants, anti-psychotics, and stomach acid medication
- underactive thyroid or hypothyroidism
- undereating including anorexia nervosa
- alcohol, and
If you have severely elevated prolactin due to a prolactinoma, you may require the medication bromocriptine. For other causes, the best strategy is to address the underlying problem. That can mean taking thyroid hormone to correct hypothyroidism or speaking to your doctor about alternatives to your antidepressant or stomach acid medication.
For mildly elevated prolactin in the range of 300 mIU/L to 500 mIU/L, you can consider natural treatment.
Natural treatments to lower prolactin
- Reduce alcohol, especially beer, because barley stimulates prolactin. That’s why beer was traditionally prescribed to increase milk supply. Do not exceed four alcoholic drinks per week.
- Address any underlying issue with thyroid or undereating.
- Reduce stress with yoga, meditation, and long slow walks.
- Consider taking vitamin B6 which lowers prolactin levels by increasing the neurotransmitter dopamine.
- Consider taking the herbal medicine Vitex agnus-castus (also called chaste tree or chaste berry) which lowers prolactin. The exact dose depends on the formulation of the product. Read The dos and don’ts of Vitex for period problems.
👉🏽 Tip: Vitex suppresses prolactin so strongly that it can mask the symptoms of a prolactinoma, so check with your doctor about high prolactin before trying natural treatment.
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