I am not pregnant, then why is my prolactin elevated?

Question

Hi doctor,

My periods were two weeks late, so I went to the doctor a couple of days ago, and the pregnancy came back negative. So, I went to have my blood drawn yesterday, and they said I had elevated prolactin. I started my period the day after I went to the doctor (or so I think), and I am bleeding now but no cramping, which is weird for me. Anyway, I have been reading up on prolactin, and it says that it will not release any eggs and you could become infertile. Now I am confused if that is true then how am I on my period? I am scared that I could be pregnant and just be reeving negative tests. Why would my body be producing milk? I have never been late on my prior periods, so I thought I was pregnant, but I clearly am not. I am just so confused. I did not get to talk to my doctor today about my results because I could not get them on the phone and they are closed now. I tend to be a worrier, and this is killing me. My doctor wants me to get re-tested for prolactin, which is what I heard in the message they left. How can you all of a sudden have issues with prolactin if you are not pregnant? This has never happened to me before. I am not sure if it is my period or implantation bleeding?

Answer 1

Hi,

Welcome to icliniq.com.

Just relax, those are too many questions. Let me say even this anxiety can cause a rise in prolactin. Let me tell you about ovulation and then about prolactin. In normal periods, your FSH (follicle stimulating hormone) rises around the 3 to 4 day of periods. This will select the best 6 to 8 follicles to grow in this cycle. The growing follicle will keep producing estrogen hormone. This hormone will suppress the FSH further, so no more follicles come forwards. Out of all the follicles, only one or two best follicles will grow, rest will shrink. Only the best follicle will reach the full size and only then the LH (luteinizing hormone) hormone will start raising, and it will make the follicle rupture. But for this good rise of LH and further hormonal balance, thyroid and prolactin hormones are needed. So if these are abnormal, the ovulation will not occur. During breastfeeding, these hormones (estrogen and progesterone) are fully abnormal, so prolactin is very very high, and it will suppress ovulation. The common reasons for high prolactin are as follows:

Anxiety, which is possible in you.
Sleeplessness.
REM (rapid eye movement) sleep.
Stimulation of nipple.
Sex.
Certain medications related to depression and gastritis.

Prolactin is under control of many hormones. It has to be checked at around 6 to 9 AM in empty stomach. If taken later or after food or if you are made to see the needle for long, and then the sample is taken, it can raise the value. Prolactin up to 30 to 36 mcg/L will not need treatment. Only if prolactin is very much elevated, that is more than 80 to 100 mcg/L, will breast milk come unless you had a baby recently. Prolactin does not affect pregnancy hormone study. You will come positive if pregnant, at any prolactin level. You do not need any treatment if values of prolactin are borderline. Try to keep your weight in the normal range of 115 to 125 lbs, as this can alter thyroid and prolactin hormone.

Hope I have been able to clarify your query, do write back. All the best.