Hyperprolactinemia
Abnormally high prolactin levels that suppress ovulation and can cause infertility in both sexes.
Prolactin is a pituitary hormone that promotes milk production. Elevated prolactin (hyperprolactinemia) suppresses GnRH, reducing FSH and LH secretion, which disrupts ovulation in women and testosterone and sperm production in men. Causes include a pituitary adenoma (prolactinoma), hypothyroidism, antipsychotic medications, and stress.
Symptoms include irregular or absent periods, galactorrhea (unexplained breast discharge), and decreased libido. Diagnosis is a blood prolactin level drawn in the morning without recent breast stimulation. Treatment with dopamine agonists (cabergoline or bromocriptine) normalizes prolactin in most patients and restores fertility without ART in many cases.
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