Short answer: High prolactin in men (hyperprolactinemia) means the blood level of prolactin, a pituitary hormone, is above the normal range, which for men is usually under 20 ng/mL. It can lower testosterone and cause low sex drive, erection problems, breast enlargement, infertility and, with a larger pituitary tumor, headaches or vision changes. The most common causes are a benign pituitary tumor called a prolactinoma, certain medications, an underactive thyroid and kidney disease. Diagnosis starts with a blood test, and treatment is a decision for your doctor or an endocrinologist, not something to manage on your own.[1][2][3]
Key Takeaways
- MedlinePlus and Cleveland Clinic list a normal prolactin level for men as less than 20 ng/mL, although reference ranges vary slightly between labs.[1][2]
- In men, high prolactin can suppress testosterone and show up as low libido, erectile dysfunction, gynecomastia, less muscle and body hair, infertility and bone loss.[3][4]
- Common causes include prolactinoma, medicines (such as some antipsychotics, antidepressants, opioids, metoclopramide and verapamil), hypothyroidism and chronic kidney or liver disease.[1][3]
- Stress, a recent meal, exercise, sex or chest irritation can raise prolactin temporarily, so a high result is often repeated before conclusions are drawn.[1][2]
- Prescription dopamine agonists (cabergoline and bromocriptine) are the standard medical treatment for prolactinomas; surgery and radiation are reserved for selected cases.[3][5]
- No supplement is a treatment for high prolactin. Headaches or loss of side vision with high prolactin need prompt medical review.[5]
What Prolactin Is and Why It Matters for Men
Prolactin (also called PRL or lactotropin) is a hormone made mostly by the pituitary gland at the base of the brain. Its best known job is to drive milk production after childbirth, but it is present in men too. Its release is held in check mainly by dopamine, which acts as a brake on the pituitary cells that make it.[2]
When prolactin stays high, it interferes with the hormone signals that tell the testes to make testosterone. The Endocrine Society notes that hyperprolactinemia can lower estrogen or testosterone and reduce fertility, and Mayo Clinic explains that a prolactin-secreting tumor lowers sex hormone levels, which is where most of the symptoms in men come from.[3][5]
That is why high prolactin often looks like low testosterone. If you have been reading about signs of low testosterone, it helps to know that prolactin is one of the hormones a doctor may check when testosterone comes back low, especially when libido is down and the reason is not obvious.
Symptoms of High Prolactin in Men
Symptoms can be vague at first and easy to blame on stress, age or poor sleep. Mayo Clinic points out that men tend to notice symptoms later than women do, so a tumor may be larger by the time it is found.[5]
Hormone-related symptoms
- Low sex drive
- Erectile dysfunction
- Breast enlargement (gynecomastia)
- Less muscle mass and less body or facial hair
- Infertility
- Bone loss over time, because lower sex hormone levels weaken bone
- Milky nipple discharge (galactorrhea), which is less common in men
These are the symptoms listed by the Endocrine Society, Yale Medicine and Mayo Clinic for men with hyperprolactinemia or prolactinoma.[3][4][5]
Pressure symptoms from a larger tumor
A large prolactinoma can press on nearby structures. Mayo Clinic lists headache and vision changes, and notes that the first sign of pressure on the optic nerve is often loss of side (peripheral) vision. Large tumors can also reduce other pituitary hormones, such as thyroid hormone, growth hormone and cortisol (a condition called hypopituitarism).[5]
| Symptom or finding | What it may point to | What to do |
|---|---|---|
| Low libido, erection problems | High prolactin lowering testosterone, among many other possible causes | Ask your doctor about testosterone and prolactin blood tests |
| Breast enlargement or tenderness | Hormone imbalance, including high prolactin | Book a medical exam and blood work |
| Fertility problems | Hormone disruption affecting sperm production | See a doctor or fertility specialist |
| New or worsening headaches with hormone symptoms | Possible pituitary tumor pressing on nearby tissue | Seek prompt medical evaluation |
| Loss of side vision | Possible pressure on the optic nerve | Urgent medical review and vision testing |
What Causes High Prolactin in Men?
Doctors separate temporary rises from sustained hyperprolactinemia. Only the second is a medical condition that needs a cause found.
Prolactinoma and other pituitary problems
Cleveland Clinic describes a prolactinoma, a usually benign pituitary adenoma, as the most common cause of hyperprolactinemia.[2] The Endocrine Society classifies tumors under 1 cm as microprolactinomas and larger ones as macroprolactinomas. Other pituitary tumors, injury, disease of the hypothalamus or radiation near the pituitary can also raise prolactin.[1][3]
Medications
Many common drugs can raise prolactin. MedlinePlus lists antidepressants, butyrophenones, estrogens, H2 blockers, metoclopramide, opioid medicines, phenothiazines, risperidone and verapamil, and notes that marijuana products can also raise levels. The Endocrine Society adds some blood pressure drugs to the list.[1][3] Never stop a prescribed medicine on your own because of a prolactin result. Your prescriber can decide whether a change is safe.
Thyroid, kidney and liver conditions
An underactive thyroid (hypothyroidism) and chronic kidney disease can both raise prolactin, according to MedlinePlus and Yale Medicine. The Endocrine Society also lists chronic liver disease, and Mayo Clinic includes an overactive thyroid among other causes.[1][3][4][5]
Temporary and lab-related causes
Emotional or physical stress, pain, exercise, eating (especially a high-protein meal), sexual activity, nipple stimulation, chest wall injury or irritation, and seizures can raise prolactin for a short time.[1][2] Some people also have macroprolactin, a large, mostly inactive form of prolactin that makes the lab result look high. The Endocrine Society says macroprolactin itself does not cause health problems, which is why doctors may test for it before ordering more workup.[3] In some cases no cause is found.[3][5]
Prolactin Levels in Men: Testing and Results
The prolactin test is a simple blood draw. MedlinePlus says it is ordered to look for pituitary tumors and to find the cause of low sex drive, erection problems or milk discharge from the breast.[1]
| Group | Typical reference value | Source |
|---|---|---|
| Men | Less than 20 ng/mL (20 µg/L) | MedlinePlus, Cleveland Clinic |
| Women, not pregnant or breastfeeding | Less than 25 ng/mL | Cleveland Clinic |
| Pregnancy or breastfeeding | 80 to 400 ng/mL | Cleveland Clinic |
Ranges vary slightly between labs, so always read your result against the range printed on your report.[1][2]
How to get an accurate result
Because stress, food and exercise can nudge prolactin up, MedlinePlus notes that a high result may be repeated in the early morning after an 8-hour fast.[1] Avoiding a workout and sexual activity shortly before the draw is sensible, and you should tell the lab and your doctor about every medicine and supplement you take. Timing matters for testosterone too; see our guide to the best time to check testosterone levels.
What a doctor may check next
If prolactin is confirmed high, the Endocrine Society says doctors typically check thyroid hormone levels, review medications and may test for macroprolactin. If a pituitary tumor is suspected, an MRI of the brain and pituitary is often the next step.[3] Mayo Clinic adds blood tests for other pituitary hormones and vision testing when a tumor could be affecting sight.[5] Many men are also checked for total and free testosterone; our articles on normal testosterone levels and free vs total testosterone explain how those numbers are read.
How High Prolactin Is Treated
Treatment depends on the cause and the severity. Both the Endocrine Society and Yale Medicine note that someone with high levels but few or no symptoms may need no treatment at all.[3][4] These are clinician decisions, usually made with an endocrinologist.
Treating the underlying cause
If a medicine is responsible, the prescriber may consider an alternative. If hypothyroidism is the cause, it is treated with thyroid hormone replacement, according to the Endocrine Society.[3]
Dopamine agonists
For prolactinomas, the standard treatment is a prescription dopamine agonist, either cabergoline or bromocriptine. These drugs lower prolactin and often shrink the tumor. The Endocrine Society notes bromocriptine is taken 2 to 3 times a day and cabergoline once or twice a week.[3] Mayo Clinic lists common side effects as nausea, dizziness, nasal stuffiness, constipation and headache, and rare risks including heart valve problems (mainly at the high doses used for Parkinson’s disease) and impulse control problems such as compulsive gambling or shopping. Stopping may be possible after prolactin has stayed normal for 2 to 3 years, but only under medical guidance.[5]
Surgery and radiation
Surgery, usually through the nose (transsphenoidal), is used when medicines do not work or cause too many side effects. Radiation is rarely used, mainly when medicine and surgery have not controlled the tumor.[3][5]
Healthy habits such as consistent sleep, regular exercise and limiting alcohol support general wellbeing, but they do not replace a medical workup. If prolactin is high because of a tumor, a medication or a thyroid problem, lifestyle changes alone will not address it.
Supplements and Prolactin: What to Tell Your Doctor
Supplements are not a treatment for high prolactin, and no herb should be used in place of testing and medical care. If you are being evaluated for a hormone problem, give your doctor a full list of everything you take, including herbal products, so results can be interpreted correctly and possible interactions with prescription medicines can be checked.
That includes Ultra Bann. It is a natural male vitality supplement made by DL Bioproducts with seven botanicals listed with their exact amounts on the label, and it is not a prolactin or hormone therapy. You can review the full Ultra Bann ingredient label and share it with your doctor. If your clinician is comfortable with it for general wellness, it is available in our shop. For a broader look at testing hormones safely, see our guide to high SHBG in men.
When to See a Doctor
- You have low libido or erection problems that have lasted for weeks, especially with low testosterone on a blood test.
- You notice breast enlargement, tenderness or nipple discharge.
- You and your partner are having trouble conceiving.
- You take a medicine known to raise prolactin and develop hormone symptoms.
- You have new headaches or any loss of vision, particularly side vision. These need prompt evaluation.
Frequently Asked Questions
What is a normal prolactin level for men?
MedlinePlus and Cleveland Clinic give a normal value for men of less than 20 ng/mL (20 µg/L). Each lab sets its own reference range, so compare your result to the range on your report and discuss it with your doctor.[1][2]
Can high prolactin cause low testosterone?
Yes. Sustained high prolactin can lower testosterone, which explains many of the symptoms men notice, such as low libido, erectile dysfunction and less muscle mass. That is why prolactin is often checked when testosterone is low without a clear reason.[3][5]
Can stress raise prolactin levels?
Emotional or physical stress can raise prolactin temporarily, as can exercise, a meal, sexual activity and chest irritation. This is why a mildly high result is usually repeated, often in the early morning after fasting, before any further testing.[1][2]
Is a prolactinoma cancer?
Prolactinomas are usually benign (noncancerous) pituitary tumors. They can still cause problems through hormone effects or, when large, by pressing on the optic nerve and nearby tissue, so they need medical follow-up.[3][4][5]
Can high prolactin in men be cured?
It depends on the cause. A medication-related rise may resolve when a doctor adjusts the drug, and thyroid-related cases are treated with thyroid hormone. Prolactinomas usually respond to dopamine agonist medicine, and some people can stop treatment after prolactin has been normal for 2 to 3 years under medical supervision.[3][5]
References
- Prolactin blood test. MedlinePlus Medical Encyclopedia, U.S. National Library of Medicine.
- Prolactin: What It Is, Function and Levels. Cleveland Clinic.
- Hyperprolactinemia. Endocrine Society, Endocrine Library.
- Hyperprolactinemia. Yale Medicine Fact Sheets.
- Prolactinoma: Symptoms and causes. Mayo Clinic.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. This article is for information only and is not medical advice.
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