Herbal Therapies for Hyperprolactinemia: Current Evidence and Future Directions

Hyperprolactinemia, a disorder characterized by excessive serum prolactin levels, can result in reproductive dysfunction, menstrual irregularities, galactorrhea, and infertility. While dopamine agonists such as bromocriptine and cabergoline are the standard treatments, they are often associated with side effects, prompting interest in herbal alternatives. Herbal therapies, including Vitex agnus-castus, Withania somnifera, Glycyrrhiza glabra, Paeonia lactiflora, and Camellia sinensis, have shown promise in modulating prolactin levels through dopaminergic activity, hypothalamic-pituitary-adrenal (HPA) axis regulation, and antioxidative mechanisms. These phytotherapeutic agents may offer a safer and more holistic approach to managing hyperprolactinemia. However, clinical evidence remains limited, with most studies being preclinical or small-scale trials. Standardization of herbal preparations, determination of optimal dosages, and comprehensive safety evaluations are necessary to establish their clinical efficacy. Future research should focus on large-scale randomized controlled trials and mechanistic studies to elucidate their roles in prolactin regulation. This review highlights the potential of herbal therapies as adjunctive or alternative treatments for hyperprolactinemia and underscores the need for further scientific validation. Keywords: Hyperprolactinemia, herbal medicine, dopamine agonists, Vitex agnus-castus, endocrine modulation