What would cause my fsh to be 4.5 and my estradiol to be <25. prolactin is 48. several symptoms of possible pituitary problems. 22 years old.

Thyroid?: In some women thyroid dysfunction can also lead to increase in Prolactin. Check your thyroid numbers and if hypothyroid get it treated. Then recheck prolactin numbers.

Need work up: With a high prolactin and low FSH level, and thus low estradiol level, I believe it is worth getting a brain MRI. You may have a tumor (typically benign adenoma) of the pituitary gland. Most certainly, you need to be followed by your GYN and preferably also by a Reproductive Endocrinology specialist.