High Prolactin and Infertility: How it could affect pregnancy

If a woman or couple wishes to become pregnant, it is important to understand their health or fertility status before starting the process. One of the key aspects is the relation between high prolactin and infertility, as it can cause hormonal imbalances.

What is prolactin?

Prolactin is a hormone produced in the pituitary gland and has an effect on almost all body cells. Elevated levels of prolactin are mainly found in pregnant women and those who are breastfeeding. This hormone is essential for the production of breast milk.

Causes of high prolactin

As mentioned earlier, elevated levels of prolactin are primarily caused by pregnancy or breastfeeding. However, in 30% of women with hyperprolactinemia, the reason remains unidentified. There may be different causes of elevated prolactin:

• Stress
• Lack of sleep
• Lack of exercise
• Protein or fat-rich diet
• Medications for depression, anxiety, or similar conditions
• Tumours in the pituitary gland
• Kidney insufficiency
• Injuries to the chest wall or spinal cord
• Adrenal gland insufficiency

What are the side effects of high prolactin levels

When a woman suffers from hyperprolactinemia, this can lead to anovulation or irregular menstrual cycles, thereby reducing the production of the necessary progesterone for embryo implantation, all of which constitute impediments to achieving pregnancy.

High prolactin treatment

The treatment for hyperprolactinemia will vary depending on the underlying reason. If it is caused by medication, the specialist is likely to recommend discontinuing the medication to restore normal prolactin levels. On the other hand, if hyperprolactinemia is related to an endocrine disorder, the specialised healthcare professional may prescribe replacement therapy with thyroid hormones. Finally, in cases such as pituitary adenomas or prolactinomas, medication with dopamine antagonists may be necessary. In general, the treatment for high prolactin levels aims to restore normal levels for the benefit of fertility.

Normal prolactin levels to get pregnant

In general, a normal prolactin level is around 2-29 ng/ml. When the concentration of this hormone exceeds 100 ng/ml, reproductive capacity can be affected. The reason for this is that elevated values can lead to polycystic ovary syndrome (PCOS), stress, hypothyroidism, or the presence of an ovarian cyst or pituitary prolactinoma.

How to reduce prolactin 

In addition to the treatment options mentioned earlier, maintaining a healthy lifestyle can also be helpful. For example, keeping stress levels low through yoga, meditation, and regular physical activity.

Foods that lower prolactin levels 

While there are no specific foods indicated to reduce elevated prolactin levels, a balanced and nutrient-rich diet can positively impact hormone levels. Foods rich in vitamin B6, such as fish, chicken, bananas, and avocados, for example.

Prolactin in pregnancy

As mentioned earlier, prolactin naturally increases during pregnancy. However, excessively high levels should be monitored by a specialist to ensure a healthy pregnancy.

Hindering ovulation 

In a woman, under normal conditions or without pregnancy, low levels of prolactin are produced. When high levels occur, they can disrupt ovulation or make it slower. This means that the ovaries may release the egg intermittently or may not release it at all. Irregular menstrual periods or their absence can be important signs for high levels. If ovulation does not occur when it should, achieving pregnancy obviously becomes more difficult.

In other cases, prolactin levels may not be as high as to cause this effect, but they may still be sufficient to affect the synthesis of progesterone, the hormone responsible for thickening the uterine walls after ovulation, during the luteal phase. Reduced progesterone levels shorten this period, so the endometrium does not reach the necessary thickness for embryo implantation. Therefore, even if fertilization of the egg occurs, the chances of becoming pregnant will be rather low.