How To Get Pregnant When Prolactin Levels Are High?
If you’re watching this video, you’ve probably been diagnosed with high prolactin, or maybe you’re just trying to find any possible cause that might explain why you just haven’t been able to get pregnant. Well, over the last 20 years that I’ve been a fertility expert, I’ve seen many members of My Hope Fertility Coaching Program suffer from high prolactin levels, and in many cases, finding this one little thing I’m going to talk about changed everything for them and was the missing piece that they needed to get pregnant and control their hormones. So in this video, talk about prolactin and also the pituitary tumor that might arise when you have high prolactin levels. I know they sound very scary or could be, but the reality is I’m going to help you identify if this is what could be affecting your fertility and, more importantly, what your next steps really should be. And if you already know that you want me to support you on your fertility journey, then I want to invite you to apply to qualify for my Hope Fertility Program so that I can be your fertility coach. All you have to do is use the link in the description below, okay? So let’s get into it.
I want to break down what is going on when your prolactin levels are high, and for that, it actually needs to start with what actually is prolactin. Well, prolactin is a group of hormones that are produced by the pituitary gland. This group of hormones is in charge of producing breast milk. That’s right; you heard me—breast milk when a woman delivers a baby and releasing the milk when the baby starts to feed. So it’s really a breast milk-producing hormone, although it does do other things, okay, and we will cross that bridge in just a moment. But that is the main thing that it is responsible for, and that’s also why when you are breastfeeding, your prolactin levels are higher, and that would be why your ovulation stops and your menstruation stops in relationship to that because the body understands that the priority is to breastfeed a child and provide nourishment and nutrients for that baby. And so the prolactin levels increase, ovulation goes away, menstruation goes away or subsides for a period of time until you’re ready to start moving forward with, you know, potentially trying for number two. So this is your body’s way of managing and regulating all of that. For some women, after you’ve been breastfeeding for a period of time, your prolactin levels will start to normalize and come down, even though you are still breastfeeding, and in some instances, you might actually even start ovulating and menstruating while you are still breastfeeding.
In other circumstances, and I see this quite often, is that women will not start a new cycle; they will not start menstruating again and ovulating again until they stop breastfeeding or severely reduce their breastfeeding so that the prolactin has the ability to drop, that those levels can come down, and then the body recognizes that it’s a safe environment to start to regulate your cycles again and ovulate and so forth. So that is what prolactin actually is and why we start to see higher levels in normal circumstances during pregnancy and afterwards.
You might be thinking, well, if prolactin is supposed to be elevated when we’re breastfeeding, then how does prolactin actually affect your fertility? Well, hyperprolactinemia, which is the term for higher levels of prolactin not at the appropriate time, so this would be when you’re not breastfeeding, right? This can impact your fertility for all the same reasons that I just mentioned because if your prolactin level is higher, it can stop you from ovulating and menstruating, and that’s not helpful when you’re trying to conceive and get pregnant, right? You need to ovulate and you need to menstruate. It can also cause irregular cycles and irregular ovulation. So there’s one extreme, which is it basically makes it all go away. The other extreme, which is a little bit less of an extreme situation, is that you’re still ovulating and menstruating but irregularly. That’s a problem because it’s difficult to track, difficult to know when it’s coming, and so difficult to time intercourse. And then the third way is that it can also cause lower progesterone levels after ovulation, which can impact your luteal phase and cause you to menstruate earlier. So these are all reasons why or how having higher prolactin levels can actually impact your fertility negatively because none of that makes sense when you’re trying to conceive naturally at home.
So how do we know if our prolactin levels are high? I mean, that would be a logical question to ask, and many of you may have already asked those questions. Actually, before I answer that question, if you have other questions related to prolactin levels that are coming up for you right now or you’ve had high prolactin levels and you’ve had difficulty regulating them and figuring that out, comment below and let me know. Post your questions there. Let me know if you’ve been diagnosed with hyperprolactinemia, and let’s start a conversation. So leave those comments below. But now, back to, “How do I know if my prolactin levels are high?” Well, you may not know without any testing, and you really might not know that they’re high, but you can start to, as hopefully you’ve already started to assume and deduce, that you can start to look at your signs and symptoms around your cycle. If your cycles are irregular or you’re having a shorter luteal phase or maybe you’re not even having any cycle whatsoever, then this would be a reason to test.
Now, typically with the couples that I support in the Hope program, this is part of our standard workup. I can tell you how often I see that prolactin was not tested for so many women, and that’s really often. I would say over 50% of the couples in the program have never had prolactin checked. That, in of itself, is a problem. So as part of our routine lab work and blood work for anyone in our program, prolactin is already part of that request. We want to make sure that we understand what’s going on there. But certainly, if you’ve had any of these irregularities, irregular cycles, irregular ovulation, short luteal phase, no cycle at all, then this is also a reason to test.
You can also have, as hopefully maybe you’ve also deduced, that you might also have discharge from your nipples if your prolactin levels are high because prolactin produces breast milk, and higher prolactin levels are going to stimulate the breast to produce breast milk. So you can have discharge if that’s the case, and that would also be a symptom of higher prolactin levels and a reason to get tested. In the end, it comes down to just getting tested. We have to make sure that you get your prolactin levels tested and that we know where they’re at so that we know if you need support in that area, okay?
So how do we get it tested? Well, the simple answer is it’s a blood test. I do feel it necessary to express a couple of things here. First and foremost, there are lots of things that can impact your prolactin levels or the results of your prolactin test. There are a lot of home tests that you can do nowadays, right, that you can order on your own, and it’s a finger prick where it’s called a blood spot test. You’ll prick your finger, push out some blood, put it onto a cloth or a paper, send it in, and they’ll test for it. Theoretically, this should be fine. I just want to express that I’ve seen a lot of variability with those results, and it makes me question them when it comes to prolactin levels, which is why I often end up retesting them.
But with that said, there’s lots of reasons why prolactin levels can be abnormally or incorrectly elevated, and I want to make sure that we cover those things as we’re talking about getting tested. So yes, it’s as simple as getting tested right with a blood test. However, you need to make sure you’re doing it in the right environment. And what do I mean by that? Well, it should be in the early part of your cycle, which is why I always request the members of The Hope program have it done on cycle day 2, 3, or 4 with their other hormone levels FSH, LH, estradiol to make it easier. So it should be in the beginning part of your cycle. It should also be first thing in the morning or early morning time. Additionally, it should be fasting because food can impact those levels.
Okay, you should not have worked out hard the previous day because a heavy workout can impact prolactin levels. Going for a nice little walk will be fine, but a strong workout, I don’t recommend. I also want to make sure that you’re not having intercourse, you’re not orgasming, and there’s no nipple stimulation for the previous 24 hours leading up to that. All of those things can also impact the results of your prolactin levels. So you might say, “Well, it’s cycle day 2, 3, or 4. I’m bleeding. I’m not going to have intercourse.” I’m going to tell you that many people have intercourse during that time frame, so let’s avoid it. Let’s not orgasm during that time, and let’s avoid nipple stimulation. And then we’re creating a proper, healthy environment to get a good, correct reading of your prolactin levels.
Now, the additional test that we might need to run if your prolactin levels are high, okay, is what’s called a monomeric prolactin test, okay? This is a more specific test, which would only be run if your first prolactin test, your total prolactin test, was elevated. Then you would run this to see if there was a problem. If this test comes back abnormal, then that’s a reason to be concerned and actually seek treatment. If this comes back normal, then you should not need additional treatment. The caveat here is there’s a lot of other things that can go wrong, and we need to look at that a little bit more closely. But in general, that is the case.
This next piece, I think, is really important. So before I get into how to treat it, what’s really important once we start to determine that there are higher levels of prolactin is that we need to rule out any other cofactors. So let’s just say you can do these all kinds of well. Most of them you can do simultaneously, if not, you’ll just get your prolactin level first, see if it’s elevated. Then from there, you can start to rule out those other secondary issues. But the most common reason that could also be seen in conjunction with high prolactin levels or influence prolactin levels is a thyroid disorder. So make sure that your thyroid looks good. It’s not just okay to test TSH; we really want to do a full thyroid panel, which I’ve discussed in many other videos that you can check out. But that would be a big issue to rule out.
Second would be other medication. Medication has side effects. Some medication can impact pituitary function and cause prolactin levels to be elevated. So we want to make sure that there’s no other medication being taken that can cause that. And for that matter, I’m also going to say supplements. There’s probably some supplements as well that can impact that. So we just need to make sure that none of those things are causing a problem. And last but not least, which is probably the biggest concern, is a pituitary tumor or cyst. That’s right. This is when there’s a small cyst or adenoma that grows on the pituitary that can cause your prolactin levels to be elevated. Nothing to be overly concerned about. Most of these are microadenomas, and we do nothing about them. But if they are large, then they might need surgery. But these are usually non cancerous, but they are impacting the pituitary and causing your prolactin levels to rise and could be, in most situations, actually impacting your other hormones and causing irregular cycles. When we do have these adenomas on the pituitary, they can actually impact your hypothalamus, and these can also impact other hormones that are essential for fertility, like FSH (follicle-stimulating hormone), LH (luteinizing hormone), and estradiol. Those are all things that can be impacted. And actually, this week, I just got results back that did show a slight elevation, not extremely high, of prolactin in one of the members of the program, and also a lower FSH, lower LH, and lower estradiol, which is exactly what I’m talking about here. And this is exactly the combination that we want to rule out and actually support.
So again, coming back to what do we do about this? How do we address the adenoma or the higher prolactin levels? Well, medication is by far the best option here. It is the most stable, the most consistent, the most predictable, the most dependable. I don’t know how else to say this. I get questions all the time because, if you all know me, I prefer to do things naturally or as in a natural way as possible. This is one of the places where I think medication is essential. I would encourage all of you, if you find out this to be the case, reach out to your doctor, have a conversation with your physician or OBGYN or fertility doctor to get on proper medication because that is going to rectify the situation the fastest and the most stable. It’s going to lower your prolactin levels, help you regulate your cycles, and put you in a good place to actually get pregnant.
And I have two stories of members from the program who this exactly happened. One woman is in Germany; she was having a hard time getting this supported. I said we can try to support it naturally, but I don’t think it’s going to be able to be stable, and sure enough, it wasn’t. And she couldn’t find any of the doctors there that would pay attention, that wanted to support it and address it until it took about 6 months when she finally found somebody who did. And now her levels are much better; everything’s in a much better place, and she’s in a much better situation to get pregnant. And then I have another member whose levels kept going high and high and high and high and higher and higher. I think her prolactin at one point was like 60 or 90, which was extremely high. They ruled out all the scary stuff that we’ve already talked about, but finally, she was able to get that lower, which allowed her cycles to regulate and get pregnant. So this is something that we see often, which is why I’m discussing it now because I want all of you to be aware of it.
There’s a reason why we do certain labs. There’s a reason why we’re checking prolactin is because we want to make sure that that’s not impacting your fertility in a negative way. All right, hopefully, you found this video valuable. Again, remember to comment below and let me know what you think about this video, what questions you have. Again, I would love to get a thumbs up if you like this video. Give me a thumbs up. And if you’re not already a subscriber to the YouTube channel, you need to be. So subscribe so you can find out when I put out another video for all of you. As I said, if you are really thinking about getting pregnant, you’re tired of guessing and trying and have been feeling like no one is listening, and you want a different approach, then head on over to marks.com. Discovery call; we’ll put that link in the description below for you to speak to a real human on my team so we can identify if having me as your fertility coach is the right next step. And I will leave you with the video on some of the myths about your ovarian reserve that I am sure you might not have heard as well. So check them out right here. And until the next video, stay fertile.