Psychosomatics of high prolactin
Prolactin is a hormone from the pituitary gland, and normally it is high during pregnancy and breastfeeding. Otherwise it can rise because of medicines, the thyroid, sleep, exercise and stress, and sometimes because of a small benign growth in the pituitary. See a doctor first: an endocrinologist will recheck the test and find the cause. If your vision gets worse or your head aches all the time, see a doctor without delay. The Ladder method adds questions about the care you carry.
Updated
When to see a doctor
Book a doctor’s appointment if you notice:
- Periods have become rare or stopped
- Milky discharge from the breasts without pregnancy
- You cannot get pregnant
- Lower sex drive
- Headaches that painkillers do not help
- Weakness, tiredness, mood swings
Start with an endocrinologist or gynaecologist: the prolactin test is repeated, your thyroid is checked (TSH, free T4) and, if needed, a pituitary MRI is arranged. Do not stop medicines you take on your own: discuss them with your doctor.
What medicine knows
The Kazakhstan Ministry of Health clinical protocol “Prolactinoma” (2017) describes hyperprolactinaemia syndrome as too much of the hormone prolactin in the blood, which in most cases disrupts the reproductive system. Prolactin is made by the pituitary, a gland at the base of the brain. Normally it is only high in women who are pregnant or breastfeeding (Imperial Centre for Endocrinology leaflet).
The protocol lists physiological reasons for prolactin to rise: sex, physical exercise, sleep, pregnancy, breastfeeding and stress. Many medicines raise it too, including antidepressants, antipsychotics and hormonal contraceptives, as do an underactive thyroid (hypothyroidism), polycystic ovary syndrome, and kidney and liver disease. Another cause is a prolactinoma, a benign growth in the pituitary.
In women, high prolactin can cause cycle problems up to periods stopping, infertility, discharge from the breasts (galactorrhoea), lower sex drive, weight gain and headaches. The protocol also mentions weakness, tiredness and mood swings. Sometimes there are no symptoms.
The test is taken in the morning, between 9 and 11, and if you have periods, on day 5 to 7 of the cycle. The protocol advises measuring prolactin several times to rule out fluctuations, including those caused by stress. A patient leaflet says even the stress of the blood test itself can raise the level. If high prolactin is confirmed and there is no other cause, a pituitary MRI is done.
A prolactinoma is most often treated with tablets, without surgery (Imperial Centre for Endocrinology). An endocrinologist chooses the treatment, together with a gynaecologist if you are planning a pregnancy.
In the Ladder method
In the Ladder method high prolactin is not explained by worry, and an endocrinologist looks for the cause. But the protocol itself names stress among the states that raise this hormone, so it makes sense to ask how you have been living in recent months.
Prolactin is called the hormone of motherhood and care. Many women with this result have been carrying everyone for years: children, parents, husband, work. The fear “I won't manage”, “I won't be able to provide” plays in the background, even when everything seems fine.
On the ladder this shows up as steps made of duties and other people's expectations. You can take them apart and decide what to keep for yourself. Treatment stays with your doctor.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
Frequently asked questions
Why is my prolactin high if I'm not pregnant?
The Kazakhstan Ministry of Health protocol names many causes: sleep, exercise, stress, medicines, an underactive thyroid, PCOS, kidney and liver disease, and also a prolactinoma, a benign growth in the pituitary. An endocrinologist finds out which one is yours after repeat tests.
Can stress raise prolactin?
Yes, the protocol counts stress among the physiological reasons for prolactin to rise and advises taking the test several times to rule out random fluctuations. So one high number is not yet a diagnosis. If prolactin stays high, the cause is looked for further.
Does high prolactin stop you getting pregnant?
It can: the protocol names infertility and cycle problems among the main signs. High prolactin is treated, and a doctor prescribes the medicine. The Imperial Centre for Endocrinology leaflet says these medicines are sometimes taken until you conceive and that this is safe. An endocrinologist and a gynaecologist make the plan.
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Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.