How long does bromocriptine take to work for hyperprolactinemia?

Doctor's Answer

Photo of Dr Abel Soh
Dr Abel Soh

Endocrinologist

Hi,

Prolactin is a hormone that is produced by the pituitary gland (see figure) which is situated in the head. The function of prolactin is to help women produce breast milk after childbirth.

Prolactin level can become higher than normal if there are abnormal cells or a growth in the pituitary gland that overproduce the hormone. Other causes of high prolactin level include some medications and hypothyroidism (under-active thyroid gland).

Too much prolactin in a woman may result in:

  • Absent or irregular menstrual periods
  • Milk leaking from the breasts
  • Difficulty in conceiving a child

In a man, if the prolactin level becomes too high, he may complain of low energy, low sex drive, difficulty in getting an erection, and/or increase in breast size and breast soreness.

Once high prolactin level is confirmed via blood test and the cause of the high prolactin level (hyperprolactinemia) is elucidated, medical treatment can be started to lower the high prolactin level. Surgery is only needed for very big growths in the pituitary gland that overproduce prolactin. Medical treatment for high prolactin level include the use of medications like bromocriptine and cabergoline.

Bromocriptine is taken once or twice a day and is effective in lowering high prolactin level. Once bromocriptine is started, high prolactin level will be lowered within 3 weeks with a steady level achieved by around 6 weeks. Bromocriptine can cause side effects such as nausea, dizziness, and nasal stuffiness. The side effects can be avoided or lessened by taking the medication with meals or at bedtime and by starting with a very low dose.

Cabergoline is another effective medical treatment for high prolactin level. It is taken once or twice a week and is much less likely to cause nausea compared with bromocriptine.

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