Lifestyle and Psychosocial Determinants of Hyperprolactinemia among Reproductive-age Women in Enugu and their Implications on Infertility: A Cross-Sectional Study

Abstract

Background: Hyperprolactinemia is a significant endocrine disorder among women of reproductive age and is strongly associated with menstrual disturbances, anovulation, and infertility. Psychosocial and lifestyle factors have been suggested as potential contributors, yet evidence from sub-Saharan Africa remains limited. This study investigated the sociodemographic, lifestyle, and psychosocial correlates of hyperprolactinemia among women of reproductive age in Enugu, Nigeria. Methods: A cross-sectional study was conducted among 60 women aged 25–44 years. Sociodemographic and lifestyle information were obtained using a structured questionnaire, while psychosocial stress was assessed using the Perceived Stress Scale (PSS). Serum prolactin levels were measured, and hyperprolactinemia was defined as ≥25 ng/mL. Associations between variables and prolactin status were assessed using chi-square tests, and Pearson correlation was used to examine the relationship between PSS scores and prolactin levels. Results: Of the 60 participants, 41.7% had elevated serum prolactin levels. Hyperprolactinemia showed no significant association with age, marital status, educational level, alcohol intake, or smoking (p > 0.05). However, significant associations were observed with occupational status and perceived stress. Unemployed women had a higher prevalence of hyperprolactinemia (63.4%) compared to employed women (28.9%; p = 0.014). Stress demonstrated a strong dose–response pattern, with the prevalence of elevated prolactin increasing from 13.3% in the low-stress group to 92.8% in the high-stress group (p < 0.0001). A moderate positive correlation was found between PSS scores and serum prolactin levels (r = 0.386, p = 0.002). Conclusion: Psychosocial stress and occupational status are significant correlates of hyperprolactinemia among women of reproductive age in Enugu. These findings underscore the need for stress reduction interventions and psychosocial assessment in infertility evaluation and management.