What Causes High Prolactin?
Prolactin is a hormone released from the pituitary gland, and its function is to promote milk production in the breast so the mother can nurse her baby. A way to remember prolactin is that ‘pro’ meaning to produce, and ‘lactin’ meaning lactation or milk.
Prolactin production is restricted by dopamine, a hormone released from the hypothalamus, so dopamine release will decrease prolactin secretion.
Prolactin levels should be high during late pregnancy and during breastfeeding. Though, it is possible for prolactin levels to be high when you are not pregnant or breastfeeding, which can cause some complications. Infertility, PCOS, and irregular periods are all symptoms of having high prolactin levels while not breastfeeding or enduring pregnancy.
Prolactin interferes with ovulation, and no ovulation means no period which explains the irregular cycles and infertility. Some factors only raise prolactin levels slightly while others can raise it more dramatically.
It’s important to discuss your high prolactin levels with your doctor to determine your root causes and if you have a prolactinoma, which may require medication.
You may be wondering: “what are the causes of high prolactin?”
By addressing the root cause, not simply just the symptom (or the hormone imbalance for that matter), we can find long-term, sustained healing.
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What causes high prolactin?
Certain daily activities can mildly raise prolactin:
1. Stress
Stress can be what causes high prolactin. When we are stressed we release high levels of cortisol, a stress hormone. In response to this, our body is trying to survive given threatening circumstances, so the body will attempt to combat the stress by initiating many other body functions. In this case, it has been shown the high levels of prolactin are released to try and gain homeostasis under high stress situations. The immune system slows down in response to stress, and prolactin has regulatory effects to help improve the immune system. This is why stress can be what causes high prolactin. Additionally, a study found that females who were exposed to childhood trauma, are more likely to have high prolactin in later life. Stress can be caused from a high pace job environment, family problems, too much exercise, and a common one is stress from the act of conceiving itself.
2. Exercise
Exercise can be what causes high prolactin levels too. A study looked at the prolactin levels in female athletes who endured a biking workout and a running workout and found that there is a threshold for the amount of exercise the women could do before they reached high prolactin levels. In another study, they had women perform yoga everyday for 6 days a week, an hour each day, for a total of 8 weeks. The pre yoga average for prolactin levels was 5.80 and after the 8 weeks it was 17.63. The increase in prolactin could be correlated to the many neural pathways that impact prolactin levels.
3. Eating
After eating a meal, the digestion of food can be what causes high prolactin levels. Studies have shown that protein is the main macronutrient which causes the increase in prolactin, so eating a lower protein diet could be beneficial to reduce the prolactin levels.
4. Sex
Sexual intercourse can surprisingly be what causes high prolactin too. A study found that both men and women experience an increase in prolactin levels after sexual intercourse that ends with orgasmic relief, and masturbation was found to not be what causes high prolactin. Additionally, a questionnaire was administered to women both with high and normal levels of prolactin. The results showed that the women who responded with dissatisfaction in libido, orgasm, and arousal all had high levels of prolactin. This can suggest that sexual satisfaction is negatively correlated with prolactin levels.
Source: 16095799
5. Mild thyroid disease
Many studies have shown that females with high prolactin may have mild thyroid disease. In this case, the thyroid disease limits the amount of thyroid hormones produced. This low production of the thyroid hormones can be what causes high prolactin levels. The reason for this is because there can be structural changes in the follicles of the thyroid which result in high production of prolactin, therefore, can inhibit the action of other sex hormones causing infertility. Additionally the study found that by supplementing the thyroid hormones, prolactin levels restored to normal.
Source: 24024022
6. Alcohol
Alcohol consumption is also another one of the factors for what causes high prolactin. This is shown in a study where participants drank .5g/kg body weight of alcohol and the results expressed a rise in prolactin levels. This effect can be due to the acute changes in dopamine levels in the hypothalamus.
7. Luteal Phase
The luteal phase is the second half the menstrual cycle after ovulation. This phase of the cycle can be what causes high prolactin levels. A study found that there is a connection to higher prolactin in the luteal phase from lower progesterone levels. Approximately 36% of participants had higher prolactin levels during the luteal phase. This observation is validated through an abnormal response to Thyrotropin-releasing hormone TRH stimulation. TRH is responsible for stimulating thyroid hormones.
Source: 7820160
Moderately high prolactin levels can be due to:
1. Thyroid Disease
Specifically, hypothyroidism is a factor for what causes high prolactin. Hypothyroidism is when the thyroid doesn’t produce enough hormones. As previously mentioned, this is a more severe case and the thyroid structure is more degraded which will cause an increase in prolactin production.
Source: 24024022
2. Kidney or Liver Disease
Prolactin levels are elevated in those with chronic kidney disease. Chronic kidney disease is signaled by the poor functioning of the kidneys which help to detoxify the blood. Those who have kidney disease can be at risk for cardiovascular disease, and high prolactin levels can accelerate this process. Prolactin levels tend to rise in patients with kidney disease mainly through the medications taken to regulate the disease. A study showed that most of the patients with high prolactin were taking medications to make the levels higher, and this is why kidney disease can be what causes high prolactin.
Liver disease is another reason for what causes high prolactin. The liver is responsible for detoxification, metabolism, and secretes bile. It has been found that patients with liver disease have increased prolactin levels. Alcohol abuse is one of the main causes of liver disease, and a correlation could be that the effect can be due to the acute changes in dopamine levels in the hypothalamus.
Source: 26958514
3. Certain Medications
There is a wide variety of different drugs that can be what causes high prolactin. The ones listed should be noted that they will increase prolactin levels.
Antipsychotics: Thioridazine, Chlorpromazine, Haloperidol
Antidepressants: Amitriptyline, Desipramine Clomipramine, Amoxapine, Sertraline, Fluoxetine, Paroxetine, Pargyline, Clorgyline
Prokinetics: Metoclopramide, Domperidone
Antihypertensive: Alpha-methyldopa, Reserprine, Verapamil
Opiates: Morphine
4. Prolactinoma
Prolactinoma is when a noncancerous tumor forms on the pituitary and causes high production of prolactin. Symptoms that come with prolactinoma are vaginal dryness, irregular periods, discharge from nipples, and low sex drive. This is why it is one of the factors for what causes high prolactin. Diagnosis is done by an mri through your doctor and will need medication to manage it.
Source: 18473017
5. Hormonal Birth Control
A longitudinal study of over 3 months concluded that women who took hormonal birth control as oral contraceptives had a significant increase in prolactin levels. The women in this study were taking less than 50 micrograms of oestrogen as their form of birth control. This is why hormonal birth control can be what causes high prolactin.
Source: 3708872
6. Alcohol
Mentioned before, but at higher amounts now, alcohol can be what causes high prolactin to be even more severe.
Very high prolactin levels can be due to:
1. Prolactinoma
Prolactinoma is the cause for very high levels of prolactin, and should be treated with medication. More information was mentioned above.
Source: NIH
Final thoughts
There are several causes of high prolactin.
It’s important to determine why your prolactin is high to see if medication is indicated for you.
It’s possible to incorporate shifts to help support healthy prolactin levels.
-Krista
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