Hyperprolactinemia: Causes, Symptoms, and How Medications Can Trigger It

When your body makes too much hyperprolactinemia, a condition where the hormone prolactin is elevated in the bloodstream. Also known as high prolactin levels, it can mess with your sex drive, menstrual cycle, and even cause milk production—even if you’re not pregnant or nursing. This isn’t rare. In fact, up to 30% of people on certain common meds end up with it, and most don’t even realize why.

At the heart of this is the prolactin, a hormone made by the pituitary gland that normally triggers milk production after childbirth. Also called lactogenic hormone, it’s kept in check by dopamine, a brain chemical that acts like a brake on prolactin release. When dopamine drops—because of a pill you’re taking, a tumor, or stress—prolactin spikes. That’s when symptoms start: irregular periods, low libido, breast milk in non-nursing women, and in men, erectile dysfunction or reduced sperm count. Many people blame stress or aging, but the real culprit might be their blood pressure med, antidepressant, or even an antinausea drug.

It’s not just about tumors. While pituitary adenomas are a cause, most cases of hyperprolactinemia are drug-induced. Medications like risperidone, metoclopramide, and even some SSRIs block dopamine receptors, tricking your brain into thinking it needs more prolactin. Even common drugs like famotidine or verapamil can nudge levels up. And here’s the thing: you might feel fine until you notice milk leaking from your breasts—or your period vanishes. That’s when you go to the doctor, get a blood test, and find out your prolactin is triple what it should be.

What’s scary is how often this gets missed. Doctors check thyroid levels, check for pregnancy, but rarely think to test prolactin unless the symptoms are obvious. Yet, fixing it can be simple: switch the drug, lower the dose, or add a dopamine agonist like cabergoline. No surgery. No chemo. Just a smarter prescription.

Below, you’ll find real cases and practical advice from people who’ve been there. You’ll learn which meds are most likely to trigger this, how to spot the early signs before it gets worse, and what to say to your doctor when you suspect something’s off. No fluff. Just what works.