Endocrine
Medicines for Hyperprolactinaemia
A raised level of the hormone prolactin — which can disturb periods, fertility and libido — often caused by a benign pituitary growth or certain medicines, and treated with tablets that lower prolactin and shrink the growth.
Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.
Quick answer
What is Hyperprolactinaemia?
Hyperprolactinaemia means there is a raised level of prolactin in the blood — a hormone made by the pituitary gland, a pea-sized gland at the base of the brain. Prolactin's main natural role is to stimulate breast milk production, so when its level is high outside of pregnancy and breastfeeding it can interfere with the body's other hormones.
- How it is treated: The right approach to hyperprolactinaemia depends on the cause.
- Self-care: Hyperprolactinaemia is mainly managed with specialist care and medicines rather than lifestyle changes, but there are still ways to look after yourself.
- When to seek help: See your GP if you have symptoms that could point to raised prolactin — such as irregular or absent periods, difficulty becoming pregnant, a milky nipple discharge unrelated to pregnancy or breastfeeding, reduced sex drive, or erectile problems in men — so the cause can be looked into.
What it is
Hyperprolactinaemia means there is a raised level of prolactin in the blood — a hormone made by the pituitary gland, a pea-sized gland at the base of the brain. Prolactin's main natural role is to stimulate breast milk production, so when its level is high outside of pregnancy and breastfeeding it can interfere with the body's other hormones. In women, this often shows up as irregular or absent periods, difficulty becoming pregnant, reduced sex drive, or a milky discharge from the nipples that is unrelated to having a baby. In men, it can cause reduced sex drive, erectile problems and, over time, reduced fertility. A common cause is a benign (non-cancerous) growth on the pituitary gland called a prolactinoma, which makes excess prolactin; other causes include some medicines, such as certain antipsychotics and a few others, an underactive thyroid, and pregnancy or breastfeeding, which raise prolactin naturally. Diagnosis usually involves a blood test to confirm the raised level, a review of any medicines that could be responsible, and, where a pituitary growth is suspected, a scan of the gland. Care is usually overseen by a specialist endocrine team.
How it is treated
The right approach to hyperprolactinaemia depends on the cause. If a medicine is responsible, the specialist may review whether it can be changed or adjusted, weighed carefully against the reason it was prescribed. Where the cause is a prolactinoma or another reason for genuinely raised prolactin, the mainstay of treatment is a group of tablets called dopamine agonists, such as cabergoline or bromocriptine. These work by acting like dopamine, the body's natural 'brake' on prolactin, to lower the prolactin level — and they are also effective at shrinking a prolactinoma, often substantially. By bringing prolactin down, they can restore normal periods and fertility, ease symptoms such as low libido or nipple discharge, and relieve any pressure a larger growth is putting on nearby structures. Treatment and monitoring are guided by a specialist endocrine team, with blood tests to track the prolactin level and, for those with a prolactinoma, scans to follow its size. Where a growth is large, it can press on the nearby nerves to the eyes, so checking for any change in vision is an important part of care. Surgery is needed only in a minority of cases, such as when tablets are not tolerated or do not work well enough.
For this condition, these medicines
Medicine classes used for Hyperprolactinaemia
Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.
Symptom checker
Symptoms that can point to Hyperprolactinaemia
Hyperprolactinaemia can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:
Beyond medication
Lifestyle and self-care
Hyperprolactinaemia is mainly managed with specialist care and medicines rather than lifestyle changes, but there are still ways to look after yourself. Keep an up-to-date list of all your medicines, including anything bought over the counter, and share it with your team, since some medicines can raise prolactin — never stop a prescribed medicine, such as an antipsychotic, on your own, but do raise any concerns so it can be reviewed safely. Attend your follow-up appointments, blood tests and any scans, as these track your prolactin level and, where relevant, the size of a pituitary growth. If you have a larger growth, report any changes in your eyesight promptly, particularly loss of side vision or blurring. If you are hoping to become pregnant, or think you might be, tell your team, as this affects how treatment is managed. Looking after your general bone health with a balanced diet, activity and adequate vitamin D is also worthwhile, because prolonged hormone disturbance can affect the bones over time.
When to get help
When to see a doctor
See your GP if you have symptoms that could point to raised prolactin — such as irregular or absent periods, difficulty becoming pregnant, a milky nipple discharge unrelated to pregnancy or breastfeeding, reduced sex drive, or erectile problems in men — so the cause can be looked into. If you are already being treated, contact your specialist team if your symptoms are not improving, if you have side effects from your tablets, or if you are planning or think you might be pregnant. Seek prompt medical advice if you develop new or worsening headaches or any change in your vision, especially loss of side vision or blurring, as a larger pituitary growth can press on the nerves to the eyes. Sudden, severe headache with visual loss needs urgent assessment.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
Answers
Hyperprolactinaemia: frequently asked questions
What medicines are used for hyperprolactinaemia?
The main medicines are a group of tablets called dopamine agonists, such as cabergoline or bromocriptine. They work by acting like dopamine, the body's natural 'brake' on prolactin, to lower the prolactin level, and they are also effective at shrinking a prolactinoma — the benign pituitary growth that often causes the condition. By bringing prolactin down, they can restore normal periods and fertility, ease symptoms such as reduced sex drive or nipple discharge, and relieve pressure from a larger growth. If a medicine you take is the cause, your specialist may review whether it can be changed instead. Treatment is guided and monitored by an endocrine team.
What causes a high prolactin level?
Prolactin is normally raised in pregnancy and breastfeeding, when it stimulates milk production. Outside of these, a common cause of a persistently high level is a benign (non-cancerous) growth on the pituitary gland called a prolactinoma, which makes excess prolactin. Some medicines can also raise prolactin, including certain antipsychotics and a few others, as can an underactive thyroid gland. Because the causes differ, diagnosis usually involves a blood test to confirm the raised level, a review of your medicines, and sometimes a scan of the pituitary gland. Identifying the cause is what guides the right treatment, so it is assessed by a specialist.
Can hyperprolactinaemia affect my fertility?
Yes — a raised prolactin level can interfere with the hormones that control the menstrual cycle and ovulation, which is why it often causes irregular or absent periods and can make it harder to become pregnant. In men, it can reduce sex drive, cause erectile problems and, over time, affect fertility. The encouraging part is that treatment with dopamine agonist tablets usually lowers prolactin effectively, which can restore normal periods and ovulation and improve the chances of conceiving. If you are hoping to become pregnant, tell your specialist team, as this affects how your treatment is planned and monitored.
Why does my vision need checking?
The pituitary gland sits very close to the nerves that carry vision from the eyes. If hyperprolactinaemia is caused by a prolactinoma that has grown large, it can press on these nerves and affect eyesight — classically causing loss of the outer, or side, parts of vision, sometimes with blurring. Checking your vision is therefore an important part of care when a larger growth is present, and treatment that shrinks the growth often relieves this pressure. Report any new or worsening change in your vision promptly, and seek urgent advice if you have a sudden severe headache together with visual loss.
Sources
Where this is drawn from
- NICE CKS: Hyperprolactinaemia.
- Society for Endocrinology
Related conditions
Browse by body system
Building a patient-information or formulary resource?
We create evidence-led, dose-free clinical references and decision aids for teams.