Estradiol Cypionate
Long-acting estradiol injection for menopause and perimenopause symptoms and for gender-affirming hormone therapy, given every one to two weeks. Prescribed and dosed by a licensed physician.
Injection
from $139/mo
Taken by mouth · Twice a week
Prolactin controlDopamine agonist
Cabergoline Tablets
Cabergoline (Dostinex, commercial brand): dopamine agonist that lowers prolactin, used when elevated prolactin appears during hormone therapy or independently. Long-acting, dosed once or twice weekly.
- Long-acting dopamine agonist; stays effective for days after one dose
- Lowers prolactin, reducing breast sensitivity and restoring sexual interest
- Once or twice weekly dosing; high compliance
- Monthly$289/mo
- Every 3 months$777 billed up front$259/mo
- Every 6 monthsBest value$1,434 billed up front$239/mo
- Free, discreet shipping
- Licensed U.S. pharmacy
- Board-certified physicians
Disclaimer: Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.
- How
- Taken by mouth
- How often
- Twice a week
- Each shipment
- 1 bottle
- Strength
- 0.5 mg (8 Count Bottle)
What is cabergoline?
(ca-BER-go-leen)
Cabergoline is a dopamine agonist that blocks prolactin release from the pituitary. It is used when prolactin levels are elevated, causing breast sensitivity, sexual dysfunction, or reduced desire. Cabergoline is long-acting: a single dose of 0.25–0.5 mg lasts days, so dosing is typically once or twice per week. It is a commercial pharmaceutical brand (Dostinex) with consistent potency.
What's in it
- CabergolineLowers prolactin
Long-acting
single dose lasts 24–72 hours; dosed once or twice weekly
Cabergoline is more selective for prolactin than bromocriptine and has a much longer half-life, improving compliance. Elevated prolactin can appear from certain medications (antipsychotics, antidepressants) or independently; cabergoline treats it directly.
Is it right for you?
Who it's for
Men with high prolactin on a blood test.
What sets it apart
It lowers prolactin; it does nothing for estrogen or testosterone directly.
Worth knowing before you start
Tell your physician about any new urge to gamble, shop or eat compulsively. It is a known, reversible effect.
What to expect
Fast sexual recovery
interest and erectile function typically improve within 1–2 weeks
Reduced breast symptoms
tenderness and sensitivity fade as prolactin normalizes
Lab-guided dosing
prolactin level drives dose adjustment
Cardiac monitoring
essential with long-term high-dose use
How cabergoline works
Day 1
US-licensed physician reviews symptoms of high prolactin (reduced desire, erectile difficulty, breast sensitivity) and orders prolactin level. Discusses cabergoline dosing.
1Week 1
Start cabergoline 0.25–0.5 mg once or twice weekly. No daily pill needed; long half-life means one dose lasts days.
2Weeks 1–2
Sexual interest and erectile function often improve within 1–2 weeks as prolactin falls. Breast sensitivity may resolve.
3Week 4
Prolactin level checked. If suppressed to normal range, dose is maintained. If still high, dose is increased or frequency adjusted.
4Beyond
Prolactin monitored every 6–12 months. Dose adjusted as needed. Cardiac screening if long-term use (yearly with >3 mg/week).
5
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
How you use it
This is the starting dose the pharmacy prints on the label. Your physician sets yours and adjusts it with you.
- How
- Taken by mouth
- Dose
- one half tablet (0.25 mg)
- How often
- Twice a week
- Each shipment
- 1 bottle
- Pharmacy label
- Take one half tablet (0.25 mg) by mouth twice weekly for 30 days.
A sample week
- M
- T
- W
- T
- F
- S
- S
Twice a week
The science of dopamine agonists
Cabergoline is a D2 dopamine receptor agonist that directly inhibits prolactin release from lactotroph cells in the pituitary. Dopamine naturally suppresses prolactin; dopamine agonists restore this suppression.
In men with elevated prolactin, cabergoline restores sexual interest, reduces breast tenderness, and improves erectile function. It is often prescribed when prolactin rises during testosterone therapy or from other causes.
Learn moreImportant safety information and common side effects
Cabergoline is a dopamine agonist used to lower prolactin. Common side effects: dizziness, nausea, headache, orthostatic hypotension (feeling faint when standing). Rare: valvular heart disease (especially with doses >3 mg/week or long-term use >5 years). Cabergoline should not be used with uncontrolled high blood pressure. Tell your physician about cardiac history, prior stroke, or uncontrolled hypertension. If you take antipsychotics or metoclopramide (which raise prolactin), discuss this with your physician, stopping them may be an option. Stop and seek care for chest pain, shortness of breath, severe dizziness, or signs of allergic reaction.
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
How it works
1.Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
2.Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
3.Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Cabergoline educational content reviewed by our physician
Scott Nass, MDDoctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
Frequently asked questions
How do I take Cabergoline Tablets?
Taken by mouth, twice a week. The starting prescription is one half tablet (0.25 mg) each time. Your physician sets your own dose and it is printed on your label.
How much arrives in each shipment?
1 bottle at the starting strength, shipped to your door from a licensed US pharmacy.
How long does cabergoline take to lower prolactin?
Cabergoline begins to lower prolactin within hours and reaches steady levels within 2–3 days. Most men notice improvement in sexual interest and breast sensitivity within 1–2 weeks. Check prolactin levels at 2–4 weeks to confirm suppression; your physician adjusts dose if needed.
What causes high prolactin?
Common causes: antipsychotics, antidepressants (especially SSRIs), metoclopramide, domperidone. Some people have higher baseline prolactin. A pituitary tumor (prolactinoma) is rare but must be ruled out with imaging. Your physician orders prolactin and may order MRI if levels are very high.
Is cabergoline safe long-term?
Cabergoline is safe for most people in standard doses (0.25–1 mg twice weekly). Long-term use at high doses (>3 mg/week) carries a small risk of cardiac valve disease, so your physician monitors this with echocardiography if you need high-dose or multi-year treatment.
Can I combine cabergoline with testosterone therapy?
Yes. Elevated prolactin can appear with or without testosterone. If your prolactin is high, cabergoline can be used alongside testosterone therapy without issue. Prolactin and testosterone do not directly interact.
How long do I take cabergoline?
As long as your prolactin is elevated and causing symptoms. If the cause is a medication (antipsychotic), stopping that drug may allow you to discontinue cabergoline. If prolactin is naturally high or from a tumor, you may take cabergoline long-term. Your physician reassesses every 6–12 months.
Restore sexual function by lowering prolactin.
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The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Individual results vary.
Sources
- 1
Cabergoline for prolactin suppression: a review of mechanisms and clinical use.
Neuroendocrinology, 2015 - 2
Cardiac safety of dopamine agonists: a systematic review and meta-analysis.
Endocrine, 2018
Cabergoline Tabletsfrom $239/mo