Can high prolactin with regular periods affects ovulation?

Question

Hi doctor,

My doctor said that I have high prolactin, almost 200, but I have regular periods.

My periods are regular and usually have an interval of 30-33 days.

I do not have any othe menstrual symptoms, other than milky nipple discharge.

I take ovulation tests every month and comes back positive on my fertile days, yet I have not been able to conceive.

My doctor said that, it is just a matter of time and that I should be able to conceive.

I want treatment for the prolactin levels because, I believe that is the reason I am not able to conceive.

I just want a second opinion please.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

High prolactin levels with galactorrhea (milky nipple discharge other than normal breast feeding) can often cause delayed ovulation and irregular menses. The ovulation kits detect the LH surge and do not exactly tell us if there has been ovulation at all.

There may be delayed ovulation which can be ascertained only by regular follicular monitoring.

An excessive PRL (prolactin) secretion decreases the pulsatile release of GnRH (Gonadotropin Releasing Hormone) impairing the pituitary production of FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone).

Furthermore it may directly impair the endocrine activity of ovarian follicles.

As a consequence: defective luteal phase, inconstant ovulation and chronic anovulation are conditions frequently observed in young hyperprolactinemic patients.
So it is important that the prolactin levels are controlled.
If prolactinoma (benign pituitary tumour that produces prolactin) has been ruled out on MRI then you may take tablet Cabergoline 0.25mg twice a week for 3 weeks and then evaluate your prolactin levels again.
And then, if required the dose can be escalated to 0.5mg twice a week depending on the response.

I hope this addresses your concerns.

Please feel free to follow up if you need any additional clarification.

Thank you.