The Power of Prolactin and How It Contributes to Hormonal Imbalance

Prolactin plays a big role in fertility, pregnancy, and breastfeeding. However, levels of prolactin can be elevated outside of that season of life leading to overall hormonal imbalance. Learn all about it below.

What is Prolactin?

Simply put, prolactin is a naturally-occurring hormone created in our brain- specifically, the anterior pituitary gland. This essential hormone is best known for being the lactation or breastfeeding hormone, but it’s also a main player in breast development. In addition, this “lactation hormone” can affect other sex hormones, including testosterone and estrogen in both men and women. Prolactin plays an essential role in the female body, but especially when it comes to conception, pregnancy, and postpartum health. It can also be elevated inappropriately affecting your overall hormonal balance.

How Prolactin Works

Prolactin levels naturally elevate during and after birth to stimulate the mammary glands to prepare for milk production. This rise in prolactin is essential for breastfeeding and it is also what prevents a woman from becoming pregnant immediately after having a baby. It does this by inhibiting the master hormone, GnRH, which would normally go to stimulate LH and FSH in the anterior pituitary gland. These hormones are in charge of ovulation, so if they are low, you don’t ovulate.

When Prolactin is Too High

In a non-breastfeeding person, male or female, prolactin levels should not be elevated. However, from a functional perspective, I frequently see high levels of prolactin in women who have never even been pregnant. 

While prolactin is an essential hormone during and after pregnancy, in women who have not recently given birth, high levels of prolactin can affect normal ovulation resulting in amenorrhea, sex drive issues, and fertility. Excess prolactin can contribute to infertility in both males and females due to GnRH (gonadotropin-releasing hormone) inhibition. According to a recent study, “Regardless of the etiology of excess prolactin, infertility ensues in both sexes due to GnRH inhibition by prolactin, as well as galactorrhea, or the inappropriate flow of breast milk in men and women.”

High prolactin stops GnRH production which normally activates LH and FSH. These two hormones are in charge of allowing a woman to ovulate each month or for a man to make sperm. In women, this can lead to infertility because when high levels of prolactin block GnRH production, the release of FSH and LH are effected, the ovaries aren’t triggered to ovulate an egg, and successful conception can become a challenge. 

Causes of High Prolactin Levels

What causes prolactin levels to be elevated when they shouldn’t be? A few things.

There is a condition called a prolactinoma, which is a brain tumor resulting in very large amounts of prolactin. That is a different conversation entirely, so what I am talking about here is functional elevation of prolactin, typically from 25-75 ng/mL. If you test and it’s above 100 ng/mL you want to rule out a prolactinoma.

Causes of functionally elevated prolactin include:

• Stress

• Low vitamin B6

• Low thyroid function

• Excessive cannabis use

• Low dopamine (the neurotransmitter in our brains that is associated with pleasure, reward, and addictive behavior)

• Certain medication for high blood pressure, acid reflux, and depression

• Birth control 

Common Symptoms of High Prolactin

How do you know you have high levels of prolactin? The best way to find out is through a blood test. I recommend talking to your doctor about testing your prolactin levels if you’re experiencing the following symptoms. Keep in mind, many of these symptoms can affect both men and women.

• Low sex drive

• Painful intercourse

• Galactorrhea (Milk secreting from your nipples when not breastfeeding)

• Vaginal dryness

• Amenorrhea

• Irregular cycles

• Bone loss 

• Infertility

• Headaches

• Fatigue

How to Regulate Prolactin Levels

Dopamine Agonists

Dopamine is a neurotransmitter that has a unique relationship with prolactin. We know that prolactin goes up when dopamine is down. When dopamine is higher, prolactin goes down. In the conventional model of medicine, dopamine agonist medications (meaning they act like dopamine) such as bromocriptine and cabergoline are treatment options for prolactin excess regardless of its etiology. I personally tend to look for the root cause and use natural medicine first and find great success without needing to use medications.

Improve Your Thyroid Function

Low thyroid function can affect prolactin, so it’s important to get this tested to see if it is an issue. I recommend running TSH, free and total T3 and T4, reverse T3, and antibodies include anti-TPO and anti-TG antibodies. I recommend working with a naturopathic doctor or functional medicine practitioner to support you in this process.

Break Up with Birth Control

Birth control may be affecting your hormones so if you feel ready to start having that conversation, take the important steps before discontinuing it, and always talk with your doctor before you do anything.

Boost Your Nutrients

We know that B6 levels affect prolactin, and if you have been or are on birth control even more nutrients are affected. Low nutrient status can also impact your thyroid so make sure you are eating a whole-food based diet with a large diversity of plants and clean protein. Also consider taking a good quality multi-vitamin or prenatal to boost your nutrient stores.

Food sources of B6 include: Turkey, grass-fed beef, pistachios, tuna, pinto beans, avocado, chicken breast, blackstrap molasses, sunflower seeds, sesame seeds.

Reduce Your Stress

Stress affects almost everything in the body, including your sex drive, fertility, mood, adrenal glands, and hormones in general. Identifying where your stress comes from and finding sustainable and realistic solutions to help you manage it is essential. I cannot emphasis this enough.

Limit Cannabis Use

Cannabis can raise prolactin in some people so if you smoke or ingest THC, consider taking 3 months off and re-testing your prolactin. If it goes down, this is an indication that it is affecting your hormones. If it does’t, consider investigating other root causes.

Vitex Agnus-Castus

My favorite way to naturally support healthy prolactin levels is by supplementing with the herb Vitex Agnus-Castus, otherwise known as Chasteberry. Vitex is a superstar herb for regulating sex hormones, including prolactin, LH, and FSH. Traditionally, it has been used to address various fertility and reproductive disorders in women.

Vitex helps to balance out FSH and LH which naturally supports progesterone, since this hormone goes up when you ovulate. It also has dopaminergic activity, meaning it acts similar to dopamine, which also helps to lower prolactin.

It’s important to note that vitex can reduce fertility in males, so this treatment should only be used with females. And, as always, be sure to work with your healthcare practitioner to determine an appropriate dose for you!

As you have seen, prolactin is a very interesting hormone. It affects many things and is affected by many things. It’s an important hormone to check yet it often isn’t. So ask your doctor if you are interested in knowing your levels!

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