Prolactin is the hormone that stimulates milk production, but it has broad effects on fertility and reproductive function in both sexes. Elevated prolactin (hyperprolactinaemia) suppresses ovulation in women and testosterone in men. It is one of the most common and most treatable causes of infertility, identified by a single blood test.
Prolactin is produced in the pituitary gland and primarily known for driving lactation. But its effects extend far beyond breastfeeding, elevated prolactin suppresses GnRH, LH, and FSH, effectively switching off the reproductive axis. In women, this causes anovulation and infertility. In men, it suppresses testosterone, causing low libido and erectile dysfunction.
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Galactorrhoea: Milk Without Pregnancy
Spontaneous breast milk production in non-pregnant, non-breastfeeding women (and even in men) is called galactorrhoea, almost always caused by hyperprolactinaemia. Prolactin testing is the first investigation for any patient with unexpected milk production, regardless of sex.
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Prolactinoma: Pituitary Adenoma
The most common cause of significantly elevated prolactin (above 200 ng/mL) is a prolactinoma, a benign pituitary tumour. This is the most common pituitary tumour in adults. The good news: prolactinomas respond dramatically to medical treatment (cabergoline or bromocriptine), rarely requiring surgery.
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Drug-Induced Hyperprolactinaemia
Dopamine-blocking medications: antipsychotics (haloperidol, risperidone), metoclopramide, domperidone, methyldopa, and some antidepressants, all elevate prolactin. Drug-induced hyperprolactinaemia is the most common cause of mildly elevated prolactin (30–100 ng/mL) and must be excluded before scanning for a prolactinoma.
When to Test
Five Reasons to Test Prolactin
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Galactorrhoea: Breast Milk Without Pregnancy
Any spontaneous production of milk or milky discharge from the breast in a non-pregnant or non-breastfeeding woman (or any such discharge in a man) must prompt immediate prolactin testing. Levels above 200 ng/mL strongly suggest a prolactinoma and require brain MRI of the pituitary.
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Irregular or Absent Periods Not Explained by Thyroid or PCOS
Elevated prolactin is the third most common cause of anovulatory infertility after thyroid disease and PCOS. When periods become irregular or stop and thyroid function is normal, prolactin is the next test. Treating hyperprolactinaemia with cabergoline often restores fertility rapidly.
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Unexplained Infertility Investigation
Prolactin is part of the standard female infertility workup (alongside FSH, LH, AMH, progesterone). Even mildly elevated prolactin in the normal-to-borderline range (20–29 ng/mL) can impair implantation. Elevated prolactin combined with normal cycle may be missed without testing.
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Men with Low Libido, Erectile Dysfunction, or Infertility
In men, prolactin is part of the male infertility hormonal screen alongside testosterone, LH, and FSH. Elevated prolactin suppresses testosterone production, causing the same symptoms as primary low testosterone but with a completely different (and very treatable) underlying cause.
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Monitoring Prolactinoma Treatment
Patients on dopamine agonist treatment (cabergoline, bromocriptine) for prolactinoma require serial prolactin monitoring, every 3–6 months, to assess treatment response and guide dose adjustment. Normalisation of prolactin confirms effective treatment before considering dose reduction.
Prolactin Interpretation Guide
Normal (female)
2–29 ng/mL
Normal (male)
2–18 ng/mL
Mild elevation
30–100: repeat test
Significant elevation
>200: scan pituitary
⚕️ Prolactin rises transiently with stress, exercise, sexual activity, breast stimulation, and eating. A single elevated result should be confirmed with a repeat morning fasting sample before acting clinically.
Preparation
How to Prepare for Your Prolactin Test
Prolactin is highly susceptible to stress and stimulation, follow these steps to avoid a falsely elevated result.
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Morning Sample: Rest 30 Minutes First
Prolactin rises with physical activity, emotional stress, and even the stress of venepuncture. Arrive early, sit quietly for 30 minutes before your blood draw. Avoid exercise for 24 hours before testing. A basal morning sample taken after rest gives the most reliable result.
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List All Medications: Especially Antipsychotics
Antipsychotic medications, metoclopramide (for nausea), domperidone, and some antidepressants substantially elevate prolactin as a side effect. Tell us every medication you take. Drug-induced hyperprolactinaemia is managed by changing the medication, not by treating a pituitary tumour that doesn't exist.
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Avoid Breast Stimulation Before Testing
Nipple stimulation (including examination) raises prolactin acutely. Avoid breast stimulation in the 24 hours before testing. Do not allow a breast examination immediately before the blood draw. Tell us if this occurred, as it could make a mildly elevated result difficult to interpret.
Why Choose Us
Trusted Hormone Testing in Akoka & Beyond
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Correct Protocol: Rest Before Draw
Many labs draw prolactin without resting protocol, producing falsely elevated results that cause unnecessary MRI scanning and anxiety. We follow correct pre-draw resting protocol as standard, ensuring your prolactin result reflects your true baseline.
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Repeat Testing for Mildly Elevated Results
A single mildly elevated prolactin (30–100 ng/mL) frequently normalises on repeat testing, particularly if the first test was done under stress. We advise appropriate repeat testing before clinical decisions are made, avoiding unnecessary investigations.
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Integrated Hormone Panel
Prolactin does not exist in isolation. When hyperprolactinaemia is confirmed, we ensure TSH is checked (hypothyroidism elevates prolactin) and testosterone or LH/FSH is available. We give your doctor the full hormonal picture, not an isolated abnormal number.
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Completely Confidential
Prolactin concerns: including galactorrhoea in men or milk production outside pregnancy, can be sensitive. We handle every test with professional discretion and never share results without your explicit consent.
"I was producing breast milk and wasn't pregnant, terrifying. Mascot Healthcare tested my prolactin: 340 ng/mL. They referred me immediately for a pituitary MRI. I had a small prolactinoma. Two months of cabergoline and my prolactin normalised. The whole thing was identified and treated because they tested quickly."
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How should I prepare?
See our test and scan preparation guide. Good to know for this test: Morning sample before 10am; Rest 30 min before. If you are unsure, message us on WhatsApp before you come.
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