What are the symptoms of high prolactin in women?

Bottom lineHigh prolactin in women most often shows up as irregular, infrequent, or absent periods, milky nipple discharge outside pregnancy (galactorrhea), low libido, vaginal dryness, painful sex, and difficulty conceiving, with bone thinning over the longer term from sustained low estrogen. Some women have no symptoms at all. Headache with vision changes, especially loss of side vision, suggests a larger pituitary tumor and needs prompt medical attention. Symptoms roughly track the level, from a shortened luteal phase at 20 to 50 ng/mL to periods stopping above 100.

The most common symptoms are irregular or absent periods, milky nipple discharge, low libido, vaginal dryness, and trouble conceiving. Some women have no symptoms at all and are only found through a blood test done for another reason.

The common signs

• Irregular, infrequent, or absent periods - by far the most common presentation
• Trouble getting pregnant, often because ovulation has stopped
• Galactorrhea - milky discharge from one or both nipples when you are not pregnant or breastfeeding. It can be subtle enough that you only notice it if you check.
• Low sex drive
• Vaginal dryness and painful sex - knock-on effects of the low estrogen that follows when ovulation stops
• Acne or unwanted hair growth in some women
• Bone thinning over the longer term, again driven by sustained low estrogen

Signs that need prompt attention

Headache together with changes in vision, particularly loss of side vision, suggests a larger pituitary tumor pressing on the optic nerves. That is a reason to be seen promptly rather than at the next available appointment.

Symptoms track the level

Roughly: 20 to 50 ng/mL may only shorten your luteal phase, 50 to 100 ng/mL often makes periods infrequent, and over 100 ng/mL usually stops them. See what a normal prolactin level is.

Because these symptoms overlap with thyroid problems, PCOS, and perimenopause, they are worth a blood test rather than a guess. Read the full guide to prolactin in women.

Femora turns "my periods have been odd lately" into a dated record your clinician can actually use.