From the Guidelines
Low prolactin levels typically don't require specific treatment unless they're causing symptoms, and the approach depends on identifying and addressing the underlying cause. If you have low prolactin, potential causes include pituitary gland damage, certain medications like dopamine agonists, genetic factors, or other hormonal imbalances 1. Symptoms are often minimal but may include reduced breast milk production in nursing mothers, fertility issues, or menstrual irregularities in women. Some studies suggest that prolactin levels may be affected by various factors, such as energy deficiency-related amenorrhea, polycystic ovary syndrome (PCOS), or certain medications like antiepileptic drugs 1. However, these studies may not be directly related to low prolactin levels, and more research is needed to fully understand the relationship between these factors and prolactin levels. If you're experiencing symptoms, consult an endocrinologist who may recommend hormone replacement therapy in specific cases, particularly for women having difficulty breastfeeding. Blood tests to check other hormone levels are important as low prolactin may be part of a broader hormonal issue. Prolactin plays important roles in reproductive health, immune function, and metabolism, which is why significant deviations from normal levels warrant medical attention to ensure overall hormonal balance. In general, it's essential to prioritize the identification and treatment of underlying causes of low prolactin levels, rather than just treating the symptoms, to ensure the best possible outcomes in terms of morbidity, mortality, and quality of life. Some key points to consider when evaluating and managing low prolactin levels include:
- Identifying and addressing underlying causes, such as pituitary gland damage or hormonal imbalances
- Monitoring symptoms and adjusting treatment as needed
- Considering hormone replacement therapy in specific cases, such as women having difficulty breastfeeding
- Conducting regular blood tests to check other hormone levels and ensure overall hormonal balance.
From the Research
Low Prolactin Overview
- Low prolactin, also known as hypoprolactinemia, is a condition where the level of prolactin in the blood is lower than normal 2.
- Prolactin is a hormone produced by the pituitary gland that plays a crucial role in various physiological processes, including lactation, reproduction, and metabolism 2, 3.
Diagnosis of Low Prolactin
- The diagnosis of hypoprolactinemia is based on low or undetectable serum prolactin levels and the absence of a sufficient prolactin peak in the thyrotropin-releasing hormone (TRH) stimulation test 3.
- Basal prolactin levels of at least 5 ng/mL for males and 7 ng/mL for females can be used as cut-off levels for normal prolactin reserve 3.
- Minimum peak prolactin responses of 18 ng/mL for males and 41 ng/mL for females to TRH stimulation can exclude hypoprolactinemia 3.
Effects of Low Prolactin
- Hypoprolactinemia has been associated with metabolic dysfunctions, such as type 2 diabetes mellitus, fatty liver, dyslipidemia, fertility problems, sexual dysfunction, and increased cardiovascular disease 3.
- Low prolactin levels can also affect lactation, as prolactin is essential for milk production and secretion 4, 5.
Treatment and Management
- There is no specific replacement therapy available for hypoprolactinemia, and treatment is often focused on managing the underlying cause of the condition 2.
- Metoclopramide and domperidone, which are gastrointestinal motility agents, can increase pituitary prolactin secretion and breast milk production, but their effectiveness may vary depending on individual factors, such as parity 4, 5.