Which class of medication is used to treat hyperprolactinemia to restore fertility?

• A. Dopamine agonists
• B. Beta-blockers
• C. Antivirals
• D. Antibiotics

Answer: (A)

Hyperprolactinemia disrupts fertility because high prolactin inhibits GnRH release from the hypothalamus, which blunts LH and FSH secretion and prevents ovulation. The way to reverse this is by lowering prolactin levels, and the most effective way is with dopamine agonists. These drugs activate dopamine D2 receptors on lactotroph cells in the pituitary, suppressing prolactin secretion. As prolactin falls, normal GnRH pulsatility resumes, allowing ovulation to occur and fertility to be restored. This class is the first-line treatment for hyperprolactinemia-related infertility, with bromocriptine and cabergoline being common examples. The other options don’t address prolactin production or its impact on the reproductive axis, so they aren’t appropriate for treating hyperprolactinemia-driven infertility.