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Updated: Oct 25 2018


  • Introduction
    • Source
      • lactotrophs in the anterior pituitary synthesize prolactin
        • during pregnancy there is an increase in lactotrophs
        • it is chemically similar to growth hormone
    • Regulation
      • prolactin secretion is regulated by chemicals that alter prolactin gene transcription
        • stimulatory
          • thyrotropin-related hormone (TRH)
          • pregnancy
          • breastfeeding
            • suckling stimulates afferent fibers to inhibit hypothalamic dopamine secretion
          • dopamine antagonists such as anti-psychotics
          • sleep
          • stress
        • inhibitory
          • dopamine
            • this is a catecholamine that tonically inhibits prolactin secretion in non-pregnant and non-lactating patients
            • dopamine mainly arises from hypothalamic dopaminergic neurons
              • there are also dopaminergic neurons in the posterior lobe of the pituitary
          • dopamine agonists
            • cabergoline
            • bromocriptine
          • prolactin
            • it inhibits its own secretion via upregulating hypothalamic dopamine synthesis and secretion (negative feedback)
          • somatostatin
    • Function
      • milk production (lactogenesis)
        • prolactin stimulates the production of milk components (e.g., lactose and casein)
          • during pregnancy elevated levels of estrogen and progesterone decrease prolactin receptor numbers in the breast
            • this is why lactation does not occur during pregnancy but at parturition
              • recall that at parturition estrogen and progesterone levels decrease
      • breast development
        • stimulates the mammary ducts to proliferate and branch
          • this is accomplished with the help of estrogen and progesterone
      • inhibits ovulation
        • prolactin inhibits gonadotropin-releasing hormone (GnRH) synthesis and secretion
          • this explains why fertility is decreased during breastfeeding
    • Clinical correlate
      • hyperprolactinemia
        • etiology
          • prolactinoma
          • antipsychotics
        • symptoms
          • galactorrhea
          • infertility
        • treatment
          • dopamine agonists such as
            • cabergoline
            • bromocriptine
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