Can hypothyroidism cause hyperprolactinemia and infertility? Should I treat hypothyroidism or hyperprolactin first? Answer: Hypothyroidism can cause increased prolactin and lead to infertility, so treat hypothyroidism first. The reasons are as follows: 1. Why does hypothyroidism cause increased prolactin? Does this happen to all hypothyroid patients? Hypothyroidism is a decrease in the thyroid gland’s ability to work (the medical term for insufficient secretion of thyroid hormones), and TSH (thyrotropin) and TRH (thyrotropin-releasing hormone), the superior organs of the thyroid gland, have to come forward to urge the thyroid gland to work. However, in addition to making the thyroid work hard, the elevated TRH (thyrotropin-releasing hormone) also makes the prolactin (PRL) secreting cells work more, so you will see elevated prolactin (PRL) in hypothyroidism, and this prolactin (PRL) can interfere with ovulation and cause infertility. Therefore, infertility due to elevated prolactin caused by hypothyroidism must be treated first. Please note that this does not happen in all patients with hypothyroidism, and there is no predictive way for doctors to know which patients will have elevated prolactin, and only testing for prolactin (PRL) can tell. 2, hypothyroidism caused by increased prolactin, first treatment of hypothyroidism or direct treatment of prolactin? Since hypothyroidism is the cause of increased lactogen, if hypothyroidism causes increased lactogen and leads to infertility, hypothyroidism must be treated first. 3.After the hypothyroidism is well controlled, will the prolactin also return to normal and I can get pregnant? When hypothyroidism is well controlled and TSH is below 2.5 range (preferably 1-1.5), prolactin (PRL) caused by hypothyroidism will also naturally enter the normal range. When thyroid function and prolactin (PRL) are at ideal levels, it means that problems such as ovulation are not interfered with by thyroid function and prolactin, and in theory, you should be able to get pregnant. At this point, you can go about preparing for pregnancy as a normal person. Please note: 1. After pregnancy, you should review your thyroid function and adjust the TSH to the corresponding ideal level at the gestational week. 2, there are many factors affecting ovulation, are other factors present? If the data of thyroid gong and prolactin are normal but you are not pregnant, you should look for other reasons. 3.How to take medication for hypothyroidism combined with hyperprolactinemia? Hyperprolactinemia caused by hypothyroidism can be corrected by adjusting the dosage of Eugenol. Bromocriptine treatment is required only if the combination of pituitary prolactinoma is clearly diagnosed by an endocrinologist. 5.How often should I be reviewed? What items should be checked and what indicators should be monitored? At what state can I get pregnant? Generally speaking, the checkups should be conducted once every 1-2 months, and it is necessary to check thyroid function (FT3, FT4, TSH) and prolactin (PRL). If the professional doctor determines that the above indicators are ideal, you can prepare for pregnancy.