What are the causes of elevated prolactin levels by more than two times?

　　A prolactin level more than twice the normal may be caused by pregnancy, stress, drug side effects, hypothyroidism, polycystic ovary syndrome (PCOS), and other factors. Management should be based on the specific situation. It is recommended to visit a hospital promptly and follow medical advice for treatment.

　　1. Pregnancy: During pregnancy, hormone levels in women undergo significant changes in preparation for future breastfeeding, resulting in a marked increase in prolactin secretion. This is a normal physiological phenomenon that does not require specific drug treatment. After childbirth, prolactin levels will gradually return to normal as the body recovers.

　　2. Stress: Stressful situations such as intense physical activity, high mental tension, and chronic sleep deprivation can stimulate the hypothalamus to secrete more prolactin-releasing factors, thereby increasing prolactin secretion. It is recommended to maintain a regular sleep schedule, ensure adequate rest, avoid prolonged high-intensity exercise, and relieve mental stress through activities like listening to music or taking walks.

　　3. Drug Side Effects: Long-term use of medications such as antipsychotics and antihypertensives may affect the hypothalamic regulation of prolactin, leading to elevated prolactin levels. If drug-induced, consult a physician to determine whether dosage adjustments or medication changes are possible.

　　4. Hypothyroidism: Insufficient secretion of thyroid hormones causes a compensatory increase in prolactin secretion by the pituitary gland to maintain metabolic balance. Common symptoms include fatigue, cold intolerance, excessive sleepiness, and constipation. Patients can follow medical guidance to use medications such as Yikang Capsules, levothyroxine sodium tablets, or thyroid extract tablets to alleviate symptoms.

　　5. Polycystic Ovary Syndrome (PCOS): Due to endocrine and metabolic abnormalities, the ovaries produce excessive androgens, which interfere with the normal function of the hypothalamic-pituitary-ovarian axis, causing elevated prolactin levels. Symptoms include menstrual irregularities, hirsutism, obesity, and infertility. It is recommended to follow medical instructions to use medications such as ethinylestradiol cyproterone acetate tablets, metformin hydrochloride tablets, or spironolactone tablets to improve symptoms.

　　In daily life, it is recommended to maintain a bland diet, avoid spicy and irritating foods, ensure adequate rest, and avoid excessive fatigue to prevent adverse effects on health.

　　References:

　　[1] Gao Lisha, Ni Honggang, Du Zhengju, et al. Integrated Traditional Chinese and Western Medicine in the Diagnosis and Treatment of Hyperprolactinemia: Two Case Reports[J]. Medical Theory and Practice, 2025, 38(04):716-718.

　　[2] Tong Mei, Zhou Hongmei, Xu Xiaoxia. Diagnostic Value of Transvaginal Ultrasound Combined with Red Cell Distribution Width and Prolactin in Endometriosis[J]. Maternal and Child Health Care of China, 2024, 39(24):5024-5027.