--- title: "High prolactin (hyperprolactinaemia)" description: "What high prolactin can mean for your periods, why medicines matter, and which headache or eyesight changes need urgent help." url: "https://myruva.co/learn/high-prolactin-hyperprolactinaemia" language: "en-GB" topic: "Hormones" published: "2026-10-18" updated: "2026-10-19" author: "Ruva team" reading_minutes: 4 --- # High prolactin (hyperprolactinaemia) What high prolactin can mean for your periods, why medicines matter, and which headache or eyesight changes need urgent help. *Written and reviewed by the Ruva team · Updated 2026-10-19 · Hormones* ## Key points - High prolactin can cause irregular or missing periods and milky fluid from the nipples. - Medicines and several health conditions can raise prolactin. - A prolactinoma is a growth in the pituitary gland that is not cancer. - A sudden, extremely painful headache needs emergency care. Periods that stop and milky fluid from the nipples can be signs of raised prolactin. Prolactin is a hormone made by the pituitary gland at the base of the brain. It helps the breasts make milk, and it rises during pregnancy and breastfeeding. If your level is raised at other times, a clinician will need to look for the reason. ## Why it can affect periods High prolactin can upset the hormone signals that keep the ovaries working. This lowers oestrogen and can affect fertility. Symptoms can include irregular or missing periods, less interest in sex and vaginal dryness. Lower levels of sex hormones can also lead to bone loss. Not everyone with high prolactin has fluid from the nipples, so you can have the condition without it. Nipple fluid can also have other causes, and it needs checking in its own right. ## A raised result does not always mean a tumour Some medicines can raise prolactin. These include some antipsychotics, medicines for nausea and vomiting, some blood-pressure medicines and opioid painkillers. An underactive thyroid or kidney disease can also raise it. Bring a full list of your medicines to your appointment, including ones prescribed by another service. A prolactinoma is a growth in the pituitary gland that makes prolactin. It is not cancer. Other growths near the pituitary gland can also raise the level. Larger prolactinomas can press on nearby parts of the brain and cause headaches or problems with eyesight. Sometimes no cause is found. Prolactin can rise for a short time after exercise, the stress of having blood taken, or touching the nipples. If a result is only a little high, a clinician may repeat the test before deciding what it means. Ask how to prepare for the repeat test. Don’t try to make sense of one result using a range you found online. ## What the tests look for Your clinician will start with a prolactin blood test and ask about your medicines and health history. Other tests can check your thyroid, rule out pregnancy and sometimes look for macroprolactin. This is a form of prolactin that doesn’t cause health problems. If a growth in the pituitary gland is suspected, an MRI scan can show its size and where it is. ## Treatment depends on the cause and your priorities Some people with raised prolactin and few or no symptoms don’t need treatment. If a medicine is part of the cause, the prescriber can talk about other options. Don’t stop or change a prescribed medicine without talking to your doctor. This includes medicines for mental health. Prolactinomas are often treated with medicines called dopamine agonists, such as cabergoline or bromocriptine. These lower prolactin and can shrink the growth. Surgery is another option if medicines don’t suit you or don’t work. Radiotherapy is used less often. Your specialist or pharmacist can advise about your treatment. Tell your specialist if you want to get pregnant or find out you are pregnant. Treatment can bring back fertility, and pregnancy needs its own plan for medicines and check-ups. Ask what to do if a pregnancy test is positive. Ask too who to contact about symptoms while you wait for an appointment. If a prolactinoma is confirmed, the doctor may check other pituitary hormones. Depending on the size of the growth, they may also arrange an eye test. At follow-up appointments, your doctor will look at your symptoms and the effects of the growth as well as your prolactin result. Ask which changes to report between appointments and how to reach the team. ## Headache and vision changes: where to get help Call 999 now in the UK or 911 in the US, or your local emergency number, if a headache starts suddenly and is extremely painful, or you have a headache with loss of vision. For a headache with new problems with your eyes or eyesight, get help today. In the UK, contact an urgent GP service or NHS 111. Elsewhere, contact your doctor or an urgent care service. Emergency symptoms come before a routine hormone appointment. Book a routine GP or doctor appointment for fluid from the nipples or periods that stop or become irregular. Say when the changes started and bring the names of your medicines. Ask what your doctor is checking for and when your next review will be. ## When to get help - **Emergency:** Call 999 now (UK) or 911 (US), or your local emergency number, if a headache starts suddenly and is extremely painful, or you have a headache with loss of vision. - **Same day:** Contact an urgent GP service or NHS 111 today (UK), or your doctor or urgent care service (US or elsewhere), if you have a headache with new problems with your eyes or eyesight. - **Book an appointment:** Book a GP appointment (UK), or see your doctor (US or elsewhere), for fluid from the nipples or periods that have stopped or become irregular. ## Where you live Services and advice differ between countries. - **UK:** The NHS advises getting fluid from either nipple checked by a GP. A headache with eye or eyesight problems needs urgent advice. - **US:** NIDDK describes prolactin blood tests and, if needed, scans of the pituitary gland. MedlinePlus advises emergency care for a sudden, explosive headache. - **Elsewhere:** Elsewhere, ask your local doctor about checks and referral to a hormone specialist (endocrinologist). Use local urgent or emergency care for the headache warning signs described here. ## Sources 1. [Prolactinoma](https://www.niddk.nih.gov/health-information/endocrine-diseases/prolactinoma), NIDDK 2. [Headaches](https://www.nhs.uk/symptoms/headaches/), NHS 3. [Headache](https://medlineplus.gov/ency/article/003024.htm), MedlinePlus 4. [Nipple discharge](https://www.nhs.uk/symptoms/nipple-discharge/), NHS 5. [Current evaluation of amenorrhea: a committee opinion](https://www.asrm.org/practice-guidance/practice-committee-documents/current-evaluation-of-amenorrhea/), ASRM 6. [Hyperprolactinemia](https://www.endocrine.org/patient-engagement/endocrine-library/hyperprolactinemia), Endocrine Society --- This guide is general information to help you keep and use your own records. It isn’t medical advice. If you’re worried about a symptom, or something changes suddenly, talk to a doctor, nurse or pharmacist.