Overlooked and Undertreated: High Prolactin and Male Fertility

Agnes Ryu

When a couple struggles to conceive, the initial reaction is often to assume it must be a female fertility issue. Yet experts estimate male factor infertility plays at least some role in around 50% of cases. Unfortunately, fertility testing and treatment still tend to focus heavily on women. Considering how common issues like high prolactin are for would-be fathers, it’s time the male side received more careful investigation.

What Is Prolactin and Why It Matters for Men

First, what exactly is prolactin? It is a hormone released from the brain’s pituitary gland that enables women to produce breast milk after childbirth. However, both men and women normally secrete small amounts of prolactin. It interacts with key sex hormones like estrogen and testosterone to regulate reproduction.

In men specifically, having moderately high prolactin levels tells the testes to stop making as much testosterone. Over the long run, this hampers sperm production and testicle function. That’s why checking prolactin is important when evaluating possible male factor infertility. Left ignored for too long, high prolactin also puts men at increased risk for lowered libido, erectile dysfunction, chronic fatigue, and emotional issues.

Common Causes of High Prolactin in Men

There are various reasons men can suffer from excessively high prolactin:

  • Pituitary gland tumors – Although usually non-cancerous, they prompt the pituitary region to release more prolactin. Microadenomas and macroadenomas are most likely with size determining how extremely high prolactin rises.
  • Hypothyroidism – When the thyroid is underactive, the intricate interplay between hormones goes awry. The pituitary tries to compensate by pushing more prolactin out.
  • Liver or kidney disease – Serious disease in these filtration organs allows prolactin clearance rates to drop abnormally low.
  • Certain medications – Anti-anxiety medicines, blood pressure drugs, pain relievers, and stomach/ulcer medications contain ingredients that stimulate higher prolactin as a side effect.

Overlooked Prolactin Testing in Fertility Care

Normal laboratory reference ranges classify “normal” prolactin levels in men as anything less than 20 ng/mL. However, many integrative fertility specialists argue beneficial “optimal” prolactin for male reproduction and sexuality is under 10 ng/mL. Values at 12-15 ng/mL or higher often go unnoticed unless a male patient specifically requests more detailed prolactin blood testing.

That’s unfortunate considering endocrinology research has connected even mildly high prolactin to:

  • Reduced sperm motility and structural abnormalities
  • Lower total sperm output volume
  • DNA fragmentation in sperm
  • Abnormal regulation of testosterone and weakened testicular function

Without catching and correcting elevated prolactin, a man’s fertile potential keeps suffering in silence. Though women receive more diagnosis and treatment attention, undoing overlooked male factor risks could resolve a significant portion of “unexplained infertility.”

An Integrative Approach to Lowering Prolactin

If blood tests do show prolactin over 10-12 ng/mL, the wise next step is confirming whether a benign pituitary tumor is to blame. An MRI scan visualizes the condition to guide appropriate management. Because excess prolactin is so pervasive in disrupting men’s overall health, from mental health to prostate health, I recommend prolactin testing be part of routine wellness screening for adult males. From there, high prolactin normalizes through:

  • Prescription prolactin-inhibiting medicines like bromocriptine or cabergoline to block excess pituitary secretion
  • Surgery if tumors prove large and resistant to medication
  • Improving thyroid health for related cases through oral or compounded thyroid hormone
  • Stopping and switching current medications that aggravate high prolactin

In Dr Ryu’s practice, we prescribe herbal remedies that demonstrated to reduce prolactin and improve semen parameters. Zinc and Vitamin E is often recommended together to modulate reproductive hormones and counter prolactin.

By giving equal attention to assessing often overlooked risk factors in men, couples receive better answers to why they experience difficulty conceiving. Addressing the potential influence of high prolactin then paves the way for improved natural fertility potential.

Agnes Ryu

Agnes Ryu

Dr. Ryu is a clinician and biochemist specializing in integrative medicine. Her clinical interests include fertility, hormones, metabolism, healthy ageing, menopause, and natural breast cancer care. As an integrative practitioner, Dr. Ryu aims to uncover the root causes of health issues and strives to empower patients with the knowledge and tools to take charge of their own health.

Shopping cart0
There are no products in the cart!