Hyperprolactinemia is characterized by elevated levels of prolactin in the blood, which is a hormone crucial for breast tissue development and lactation. This condition can arise from a prolactinoma or disruptions in the body's regulation of prolactin production.

The main signs and symptoms of hyperprolactinemia include infertility, amenorrhea, low libido, and symptoms of hyperandrogenism in women, whereas men may experience erectile dysfunction, infertility, low libido, and gynecomastia. Additionally, both genders may exhibit galactorrhea and neurological symptoms if a prolactinoma is present.

Hyperprolactinemia is diagnosed through blood tests that measure prolactin levels and requires 2 tests that show elevated levels, typically above 250 ng/mL for prolactinoma.

The main medical treatment for hyperprolactinemia is the use of dopamine agonists, such as bromocriptine and cabergoline, which help decrease prolactin production. In cases of large prolactinomas or intolerance to medication, surgery may be necessary to remove the tumor.

Vitamin B6 has been shown to reduce prolactin levels (in a manner similar to cabergoline) in women of reproductive age and may help people who are experiencing hyperprolactinemia due to antipsychotic medications. Additionally, supplementation with vitamin D may be beneficial in people with low vitamin D levels, particularly postmenopausal women who are at a higher risk of low bone density.

There are no specific dietary recommendations for hyperprolactinemia, but maintaining a healthy body weight may help reduce prolactin levels, especially for people with overweight or obesity. Certain foods, such as fennel and fenugreek, may increase prolactin levels and should be avoided by people with hyperprolactinemia.

Extracts from the chaste tree (Vitex agnus-castus) have shown promise in treating hyperprolactinemia, and some studies suggest that its effectiveness is comparable to that of bromocriptine. Additionally, Mucuna pruriens may lower prolactin and increase testosterone levels in men.

Hyperprolactinemia can be caused by various factors, including pregnancy, certain medications, hypothyroidism, and disorders of the pituitary gland, as well as chronic kidney and liver diseases. In cases in which the cause remains unknown, the condition is referred to as idiopathic hyperprolactinemia.