Women's health plays a pivotal role in community well-being and public health. Hormonal imbalances, particularly those involving prolactin, can significantly impact reproductive health, leading to menstrual irregularities, galactorrhea, infertility, and other complications. Salvia officinalis (sage) is a medicinal herb traditionally used for its therapeutic properties, including its potential to regulate hormonal balance and alleviate symptoms associated with reproductive disorders. Despite its widespread use, clinical evidence regarding its effects on prolactin levels remains limited. This study aimed to investigate the impact of Salvia officinalis on serum prolactin levels and associated clinical symptoms in women. Single-arm pre–post interventional pilot study was conducted with 50 women aged 15–52 years residing in Traghan, Libya. Participants consumed sage tea two to three times daily for two weeks, following standardized preparation guidelines. Blood samples were collected before and after the intervention to assess prolactin levels using the i-Chroma device. Paired t-tests were applied to determine the statistical significance of changes in prolactin levels. Additionally, participants were monitored for changes in common symptoms related to hyperprolactinemia, including chest pain, menstrual irregularities, and galactorrhea. The results demonstrated a statistically significant reduction in prolactin levels following the intervention (P = 0.001). The mean prolactin levels decreased notably after two weeks of sage consumption, indicating a consistent treatment effect. A significant reduction in serum prolactin levels was observed after the two-week intervention with Salvia officinalis. Moreover, participants reported substantial alleviation of clinical symptoms, including a reduction in chest pain, normalization of menstrual cycles, and decreased occurrences of galactorrhea. No severe adverse effects were reported, highlighting the safety of short-term sage use. In conclusion, Salvia officinalis was associated with a reduction in prolactin levels and improvement in related reproductive symptoms within the study population. However, given the exploratory design of the study and the absence of a control group, causal relationships cannot be established. Therefore, these findings should be interpreted with caution and considered hypothesis-generating. Further well-designed randomized controlled trials with larger sample sizes and longer follow-up periods are required to confirm these results before any clinical recommendations can be made............... Keywords:............ Salvia officinalis; Prolactin; Hyperprolactinemia; Hormonal balance; Women’s health; Reproductive health.