My prolactin is high — what should I do?
Mild elevations are often medication-related or stress/sleep artifact and are rechecked fasted, midmorning, off recent nipple stimulation. Persistent elevation prompts macroprolactin, TSH, and pituitary imaging review.
Full answer
Prolactin rises with stress, recent meals, exercise, nipple stimulation, hypothyroidism, pregnancy, and many medications (antipsychotics, metoclopramide, opiates, some antidepressants). A first elevation is rechecked fasted, midmorning, and off recent stimulation. Persistent unexplained elevation prompts a macroprolactin assay (to exclude assay artifact), TSH, pregnancy testing where relevant, medication review, and pituitary MRI for clinically meaningful elevations. In men, hyperprolactinemia can suppress testosterone and contribute to low libido and erectile changes.
Educational. Not a substitute for individualized provider review.
- Methodology — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03