While prolactin is most commonly associated with pregnancy and breastfeeding, elevated levels of this hormone—known as hyperprolactinemia—can be found in young women who aren’t pregnant or lactating. Surprisingly, this hormonal hiccup can show up completely uninvited, causing irregular periods, infertility, or even unwanted milk production, known as galactorrhoea. It can be triggered by stress, certain medications, pituitary disorders, or even excessive exercise. Interestingly, the pituitary gland—often called the “master gland”—is behind this overenthusiasm. We turn to experts to to know more.

According to Dr Archana Dhawan Bajaj, gynaecologist and obstetrician at Nurture IVF Clinic, prolactin levels naturally increase during pregnancy and lactation. However, they may also rise temporarily due to several everyday factors such as physical stress, eating meals, sexual intercourse, nipple stimulation not related to nursing, chest injury, or seizures.

Certain diseases and medications, however, can lead to persistently high prolactin levels. In such cases, the condition is medically classified as hyperprolactinaemia. As Dr Bajaj explains, these elevated levels can occur due to both physiological causes (like stress, pregnancy, and breastfeeding) and pathological ones, including pituitary tumours and hypothyroidism. Chronic renal disease and specific medications are also contributing factors.

Adding further insight, Dr Pooja C Thukral, Associate Director – Department of Gynaecology at Cloudnine Group of Hospitals, Faridabad, explains that prolactin is secreted by the pituitary gland in the brain. Its role is to stimulate milk secretion in women during and after pregnancy. However, most young girls who are neither pregnant nor lactating can still experience elevated levels of prolactin. This hormonal imbalance can be confusing and concerning.

Dr Thukral says that in young girls, a non-cancerous pituitary tumour known as a prolactinoma is one possible cause. Other factors include thyroid issues—particularly hypothyroidism—as well as certain medications for mental illness, high blood pressure, or nausea. Emotional or physical stress, polycystic ovary syndrome, kidney disease, or chest injuries can also lead to higher prolactin levels.

Discussing the symptoms, Dr Bajaj says that high prolactin levels can affect the body in multiple ways. In women, it can interfere with ovarian function, leading to menstrual irregularities and reproductive challenges. In men, elevated prolactin may impair testicular function, decreasing libido and contributing to erectile issues. It can also lead to unexpected breast milk production in individuals who are not pregnant or breastfeeding.

Dr Thukral adds, "Common symptoms in young girls include irregular or absent periods due to the disruption of reproductive hormones. Over time, this can lead to infertility. Some girls may also notice a milky discharge from the breasts." In more severe cases, where a prolactinoma grows larger, it may press on surrounding brain tissue, leading to headaches and vision problems.

Treatment options depend on the root cause. According to Dr Bajaj, if a person has high prolactin levels but no significant symptoms, treatment may not be necessary. However, when caused by a prolactinoma, the first line of treatment typically involves medication—specifically dopamine agonists, which help regulate prolactin levels and reduce tumour size.

If medications are ineffective, surgery may be required, and in rare cases, radiation therapy is considered. She also adds that if a medication is the culprit, doctors may opt for alternatives that have a lower impact on prolactin production.

Dr Thukral echoes the need for personalised treatment. She advises that the initial step often involves discontinuing or adjusting medications known to elevate prolactin—but only under medical supervision. In cases where hypothyroidism is responsible, treating the thyroid condition usually normalises prolactin levels. She says that in resistant or severe tumour cases, surgery might be necessary. Meanwhile, lifestyle interventions like yoga, meditation, and counselling can be useful in managing stress-induced elevations.

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