Why men shouldn't underestimate this hormone
Prolactin is primarily known as the "breastfeeding hormone" in women, stimulating milk production during pregnancy and lactation. However, men also produce prolactin in the pituitary gland , and this is a constant condition. In moderate amounts, it is involved in regulating the immune system and hormone balance. But persistently elevated prolactin levels can have significant effects on libido, fertility, mood, and testosterone in men.
What does prolactin do in the male body?
In men, prolactin plays a modulating role in interaction with other hormones, in particular:
- It inhibits the production of testosterone when it is elevated.
- It affects testicular function and sperm production.
- Imbalance can cause sexual dysfunction
- It is involved in the perception of stress (via cortisol and dopamine)
- It interacts with dopamine , the "motivation hormone"; too much prolactin can dampen the effect of dopamine.
A well-regulated prolactin level is therefore crucial for performance, fertility, and emotional stability.
Symptoms of elevated prolactin (hyperprolactinemia)
A persistently elevated prolactin level in men can manifest itself in various ways, sometimes subtly, sometimes very concretely:
- Loss of libido despite normal testosterone levels
- Erectile dysfunction , reduced ability to orgasm
- Fertility problems , poor sperm quality
- Breast growth (gynecomastia)
- Weight gain , especially in the chest and abdominal area
- Irritability, emotional instability
- Free testosterone levels may drop, even if the overall value appears stable.
- Rare: Headaches , visual disturbances (in case of a tumor in the pituitary gland)
A targeted laboratory examination is particularly worthwhile when combined with other symptoms.
Causes of elevated prolactin in men
An increase in prolactin can have many causes; it is not always indicative of a pathological process. Common triggers include:
- Chronic stress (increases cortisol → decreases dopamine → increases prolactin)
- Sleep deprivation or sleep apnea
- Medications (e.g., antidepressants, neuroleptics, opiates, antihypertensives)
- Permanent sexual abstinence
- Testosterone therapy without aromatase control
- Prolactinoma : benign pituitary tumor, rare but relevant
- Hypothyroidism (high TSH → prolactin also rises)
Therefore, a thorough investigation is important, including consideration of the context and possibly an MRI scan if a tumor is suspected.
How is prolactin tested?
Prolactin is measured through a simple blood test in the morning . Important:
- Blood should be drawn while at rest , as exercise, sex, or stress can temporarily distort the results.
- Values between 5 and 20 ng/ml are generally considered normal, depending on the laboratory.
- Hyperprolactinemia is diagnosed at levels of approximately 30–40 ng/ml.
- useful in parallel: testosterone, SHBG, estradiol, cortisol, TSH, dopamine metabolites
A single elevated value does not automatically mean a problem; what matters is the course, the symptoms, and the context.
How can prolactin be regulated?
Treatment depends on the cause and severity.
Lifestyle measures:
- Reduce stress: e.g., breathing exercises, regular sleep, avoid overtraining
- Optimize your diet: Sufficient protein, little sugar, rich in omega-3 fatty acids
- Improve sleep hygiene: At least 7–8 hours of sleep
- Zinc, vitamin B6, magnesium, ashwagandha: Natural dopamine boosters
- Avoid alcohol and cannabis: They can increase prolactin levels.
Medical measures:
- In case of a medication-induced increase: consider changing the medication.
- For prolactinoma: medication to lower prolactin levels (e.g., cabergoline) or surgical removal.
- In cases of testosterone deficiency and elevated prolactin: Combined hormone therapy
Important: Do not self-medicate with dopamine agonists! Only under medical supervision.
Conclusion
Prolactin is not a "female hormone," but a key regulator in the male hormonal system. Elevated levels can negatively affect libido, fertility, and mood, and are often overlooked. Anyone experiencing sexual problems, lack of motivation, or other symptoms should definitely have their prolactin levels checked. Ideally, this should be done in conjunction with testosterone, estradiol, and cortisol levels.
