Average serum prolactin in men (ng/mL)
Overview
Prolactin is primarily associated with lactation but is present in men where it plays a supportive role. Hyperprolactinaemia potently inhibits GnRH release, collapsing the entire HPG axis downstream — LH, FSH, and testosterone all fall in sequence. Causes range from pituitary adenoma (a benign tumour) to medication side effects, thyroid dysfunction, and chronic stress. It is a common but frequently missed cause of male infertility.
How It Affects Fertility
- Potent inhibition of GnRH, causing cascade collapse of LH, FSH, and testosterone
- Secondary hypogonadism with all associated fertility impairment
- Direct impairment of Sertoli cell function
- Reduced sperm count, motility, and morphology
Symptoms to Watch For
- Erectile dysfunction and reduced libido
- Gynaecomastia (breast tissue development)
- Visual field disturbances if caused by a large pituitary adenoma
- Galactorrhoea (nipple discharge — rare in men)
- Infertility without obvious cause
What You Can Do
- 1 Prolactin must be tested in any unexplained infertility work-up
- 2 Review all medications — antipsychotics, SSRIs, PPIs, and antihistamines all elevate prolactin
- 3 MRI of the pituitary is recommended if prolactin is significantly elevated
- 4 Cabergoline is highly effective and well-tolerated under medical supervision
- 5 Addressing stress and thyroid function can meaningfully reduce prolactin
This content is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making health decisions.