I have high prolactin.Will this affect my fertility?

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• High prolactin levels with galactorrhea (milky nipple discharge other than normal breast feeding) can often cause delayed ovulation and irregular menses.
• The ovulation kits detect the LH surge and do not exactly tell us if there has been ovulation at all.
• There may be delayed ovulation which can be ascertained only by regular follicular monitoring.
• An excessive PRL (prolactin) secretion decreases the pulsatile release of GnRH (Gonadotropin Releasing Hormone) impairing the pituitary production of FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone).
• Furthermore it may directly impair the endocrine activity of ovarian follicles.
• As a consequence: defective luteal phase, inconstant ovulation and chronic anovulation are conditions frequently observed in young hyperprolactinemic patients.
• So it is important that the prolactin levels are controlled.
• If prolactinoma (benign pituitary tumour that produces prolactin) has been ruled out on MRI then you may take tablet Cabergoline 0.25mg twice a week for 3 weeks and then evaluate your prolactin levels again.
• And then, if required the dose can be escalated to 0.5mg twice a week depending on the response.

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