Prolactin is a hormone produced by the pituitary gland, a small, pea-sized structure located at the base of the brain. Its most recognized function involves stimulating milk production after childbirth and supporting breast tissue development during pregnancy. Small amounts of this hormone are naturally present in both men and women.
What Prolactin Is
Beyond its primary role in lactation, prolactin is a versatile hormone with over 300 known functions throughout the body. It contributes to various physiological processes in both men and women, extending beyond reproductive functions. Prolactin is involved in regulating metabolism, influencing the immune system, and modulating fluid balance within the body. This hormone also impacts reproductive health, affecting fertility and sexual function.
Causes and Symptoms of Elevated Prolactin
Elevated prolactin levels, or hyperprolactinemia, occur when there is an abnormally high amount of this hormone in the blood in individuals who are not pregnant or breastfeeding. The most frequent cause is a prolactinoma, a non-cancerous tumor of the pituitary gland that produces excess prolactin. Other causes include certain medications (e.g., some antipsychotics, antidepressants, blood pressure medications) which can interfere with dopamine’s ability to suppress prolactin.
Underactive thyroid (hypothyroidism) can also lead to increased prolactin levels. Chronic kidney disease, chest wall injuries, and even significant stress can contribute to hyperprolactinemia. The symptoms of elevated prolactin vary between sexes but commonly include milky nipple discharge not related to breastfeeding (galactorrhea) and issues with fertility.
In women, hyperprolactinemia can cause irregular or absent menstrual periods, reduced libido, and vaginal dryness. Men may experience reduced sexual desire, erectile dysfunction, and, less commonly, breast enlargement. If a prolactinoma is the cause, individuals might also experience headaches or visual disturbances if the tumor grows large enough.
How High Prolactin Influences Anxiety
High prolactin levels can contribute to anxiety through several mechanisms. Prolactin influences neurotransmitter systems, particularly dopamine. Dopamine normally inhibits prolactin production; disruptions in this balance and associated dopamine fluctuations can affect mood regulation and emotional well-being. Research indicates high prolactin is linked to symptoms of anxiety, hostility, and depression, suggesting neuroendocrine changes influence mental states.
The physical symptoms associated with hyperprolactinemia can also indirectly fuel anxiety. For example, galactorrhea, irregular periods, infertility, and changes in sexual function can lead to significant psychological distress. This can create a feedback loop where stress and worry exacerbate anxiety. Studies show a correlation between high prolactin levels and increased anxiety, particularly in individuals with prolactinomas. Prolactin is also considered an adaptive hormone that modulates stress responses, further linking its levels to emotional well-being.
Addressing Elevated Prolactin and Related Anxiety
Addressing elevated prolactin levels begins with identifying the underlying cause. This usually involves blood tests to measure prolactin, and if elevated, further tests like thyroid function tests or an MRI of the brain to check for a pituitary tumor. A pregnancy test is also standard for women of childbearing age.
Treatment for hyperprolactinemia depends on its cause. For prolactinomas, medication, specifically dopamine agonists like bromocriptine or cabergoline, is the most common approach. These medications mimic dopamine’s effect, reducing prolactin production and often shrinking the tumor. If medication is ineffective or not tolerated, surgery to remove the tumor or, rarely, radiation therapy may be considered.
Managing anxiety linked to high prolactin involves treating the hormonal imbalance and implementing mental well-being strategies. Lifestyle adjustments, such as regular exercise, a balanced diet, and stress reduction techniques like meditation, can support hormonal balance and mood. Professional mental health support, including therapy, can provide coping skills and help individuals navigate the emotional impact of hormonal changes. Always consult a healthcare professional for accurate diagnosis and a personalized treatment plan for both elevated prolactin and associated anxiety.