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What is Hyperprolactinemia, and Can It Affect Your Fertility?
Prolactin is a hormone involved in breast development and milk production. When prolactin levels are abnormally high, it’s termed hyperprolactinemia. While not widely discussed, this condition can negatively impact ovulation and fertility. Here’s what to know about hyperprolactinemia.
Prolactin and Ovulation
During a normal menstrual cycle, prolactin levels remain relatively low to allow proper ovulation. Right before ovulation occurs, estrogen peaks triggering a surge of luteinizing hormone (LH) from the pituitary. This LH surge signals the ovarian follicle to release the mature egg for fertilization.
When prolactin is elevated, it suppresses these LH and FSH surges that control ovulation. Excess prolactin inhibits follicle development and maturation, preventing eggs from being released. This results in infrequent, irregular, or absent ovulation.
What Causes Hyperprolactinemia?
Hyperprolactinemia is often traced back to one of three origins:
Less common causes include primary ovarian insufficiency, thyroid problems, and conditions like seizures, chronic liver/kidney disease or rheumatoid arthritis. Talk to your doctor to pinpoint the cause.
Signs and Symptoms
In women not on birth control, the most common symptoms of hyperprolactinemia include:
Hyperprolactinemia is diagnosed through blood tests. A prolactin level over 20 ng/ml typically confirms the diagnosis when correlated with symptoms. Levels over 200 ng/ml warrant an MRI to check for pituitary tumors.
Testing may also reveal low estrogen and LH levels. Your doctor will investigate for any underlying causes. Fertility testing like ultrasounds evaluates ovarian function.
Can It Be Treated?
The good news is hyperprolactinemia can often be effectively treated:
With treatment, ovulation and regular cycles usually resume within a few months, restoring normal fertility. Closely monitor prolactin levels.
Getting Pregnant with Hyperprolactinemia
Successful pregnancy is extremely difficult with unmanaged hyperprolactinemia due to lack of ovulation. But fertility treatments can assist:
For many, addressing elevated prolactin levels restores normal ovulation and chances of conception either naturally or via fertility treatments. Patience and persistence is key.
Hyperprolactinemia is one potential cause of unexplained infertility to consider. Because it affects ovulation rather than egg or sperm quality, regulating prolactin levels allows conception with assistance. Don’t hesitate to get prolactin testing done along with other fertility bloodwork. Restoring balance to this hormone can be life-changing.