Hormones
High Prolactin in Men: Symptoms, Causes and Sexual Health
High prolactin in men can lower libido, cause erection problems and reduce testosterone. Learn the symptoms, common causes and when to get tested.
In short: High prolactin in men (hyperprolactinaemia) can lower testosterone, reduce sex drive and cause erection problems. Common causes include certain medicines, an underactive thyroid and small benign pituitary growths. It is diagnosed with a blood test and needs medical assessment.
What is prolactin?
Prolactin is a hormone made by the pituitary gland at the base of the brain. In women it supports breast milk production. Men also make prolactin, and it plays a role after orgasm – a short rise contributes to the refractory period.
Why high prolactin matters for men
When prolactin stays high, it suppresses the hormones that tell the testicles to make testosterone. This can cause:
- Low libido
- Erection difficulties
- Lower testosterone and less energy
- Reduced sperm production and fertility problems
- Breast enlargement or tenderness (see gynecomastia)
- Rarely, a milky discharge from the nipples
Causes
Medicines
Some antipsychotics, anti-nausea medicines and certain antidepressants can raise prolactin. Never stop these yourself – speak to your prescriber.
Pituitary growths (prolactinomas)
A small, benign growth in the pituitary gland is a common cause. Larger growths can press on nearby nerves and cause headaches or changes in vision, which need urgent medical attention.
Other causes
- Underactive thyroid – see thyroid and erectile dysfunction
- Kidney or liver disease
- Heavy stress, intense exercise or nipple stimulation can cause temporary rises
- Opioid use
Diagnosis
High prolactin is found with a blood test, usually arranged when a man has low libido, erection problems or low testosterone. If levels are high, further tests or a scan may follow. This is managed by an appropriately registered medical professional, often an endocrinologist.
Treatment
Medical treatment depends on the cause and may include adjusting medicines or prescribed treatment for a prolactinoma. Many men find libido and erections improve once prolactin returns to normal.
Natural support alongside medical care
- Manage stress and sleep well
- Limit alcohol and avoid opioids where possible
- Keep a healthy weight
- Talk openly with your partner about changes in desire
See low libido in men and low testosterone symptoms in men for related causes.
When to get checked
See an appropriately registered medical professional if you have low libido with breast changes, headaches, vision changes or fertility problems. Our naturopath in Sandton can support your overall wellbeing and refer you for testing where needed.
Why men choose our natural approach
Walk in or consult remotely
Walk in at Buccleuch, Sandton, with parking available, or consult by phone or video from anywhere in South Africa.
Natural and non-surgical
Herbal remedies and practical guidance, with no injections or surgery.
Faster appointments
Enquiries answered 24/7, with same-day appointments often available.
Transparent pricing
Consultations are R2,500, with any remedy costs confirmed before you commit.
Private self-check: 5 quick questions
Answer these honestly before you try anything new or book. They help you describe what is happening and get more from your first consultation.
- Has your interest in sex dropped noticeably compared with before?
- Are you taking any regular medicines, such as antidepressants or blood pressure tablets?
- Have you been feeling low, anxious, stressed or tired most days?
- Have you noticed erection, ejaculation or orgasm changes as well?
- Is the change affecting your relationship or how you feel about yourself?
Never stop a prescribed medicine on your own – speak to your prescriber. If low mood is affecting daily life, reach out for mental health support. A naturopath can help with natural support alongside medical care.
What happens at your first consultation
- Walk in or book online, call +27 10 205 9855 or WhatsApp +27 81 823 1313. In Gauteng, walk in at 199 Vanessa Street, Buccleuch, Sandton, where parking is available. Outside Gauteng, choose a confidential phone or video consultation. Enquiries are answered 24/7.
- Talk privately with a naturopath about your symptoms, health history, lifestyle and goals.
- Receive a personalised natural plan, with any remedy costs confirmed upfront.
- Follow up in person or remotely so your progress is reviewed and your plan adjusted.
Your health and safety
Our naturopaths use natural remedies and lifestyle support, and always check your health history and current medicines first. If anything needs medical attention we tell you honestly and refer you to an appropriately registered medical professional. Avoid unregistered “enhancement” products sold online or at markets, as SAHPRA has warned that some contain hidden ingredients.
Seek urgent medical care for chest pain, an erection lasting more than four hours, sudden weakness or other sudden symptoms.
Consultation price
A consultation is R2,500, in person or remote, and your naturopath confirms any further costs before you go ahead. See our mens clinic prices for details.
Frequently asked questions
Can high prolactin cause erectile dysfunction?
Yes. High prolactin can lower testosterone and reduce libido, leading to erection problems.
What are symptoms of high prolactin in men?
Low libido, erection problems, low energy, breast enlargement, fertility problems and sometimes headaches or vision changes.
What causes high prolactin in men?
Certain medicines, benign pituitary growths, an underactive thyroid, kidney or liver disease and opioid use.
How is high prolactin diagnosed?
With a blood test, sometimes followed by a pituitary scan.
Can high prolactin be treated?
Yes. Treatment depends on the cause and is managed by an appropriately registered medical professional.
How much does a consultation cost?
A consultation is R2,500, and any remedy costs are confirmed with you before you go ahead.
Book your consultation today
Walk in at our Sandton practice any time, day or night, or book ahead. Outside Gauteng? Book a remote consultation.
References and further reading
Reviewed by George Mulaudzi, Naturopath. This page is general information and does not replace a personal consultation. If you have chest pain, sudden symptoms or a medical emergency, seek urgent medical care.
