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Prolactinoma
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
These adenomas produce prolactin. Outside of pregnancy, prolactin levels parallel tumor size fairly closely. Increased prolactin usually causes infertility because of the inhibitory effect of prolactin on secretion of GNRH, which in turn inhibits the release of LH and FSH, thus impairing gonadal steroidogenesis and ovulation, and thereby conception. Sometimes the mass effect of a macroadenoma can also lead to infertility. Prolactinomas are usually benign and nonhereditary.
Pituitary incidental adenomas
Published in Nadia Barghouthi, Jessica Perini, Endocrine Diseases in Pregnancy and the Postpartum Period, 2021
In normal pregnancyProlactin levels may rise to 300 ng/mL or more (nonpregnant normal: <25 ng/mL).Growth hormone (GH) levels are elevated due to estrogen effects and placental GH.Cortisol, adrenocorticotropic hormone (ACTH), and corticotropin-releasing hormone (CRH) are altered due to estrogen effects on cortisol-binding globulin (CBG), decreased clearance of cortisol, and production of CRH from the placenta, fetal membranes, and decidua.4
A Clinician’s Approach to Initiating Breastfeeding
Published in Fima Lifshitz, Childhood Nutrition, 2020
Susan K. Schulman, Audrey Rosner
Useful facts in review: When there is adequate breast tissue present, there is marked enlargement of the breasts during pregnancy.Prolactin is the main hormone responsible for milk production.The most potent stimulus for prolactin release is the nerve stimulation during suckling.The hormone responsible for the “let-down” reflex which ejects the milk from the alveoli into the collecting system and out through the nipple pores is oxitocin.The most potent stimulus for oxitocin release is suckling. Other cognitive stimuli such as hearing the baby cry also contribute to oxitocin production.During lactation mothers usually experience amennorhea and infertility.
Relevance and therapeutic implication of macroprolactinemia detection using PEG 6000 in women of childbearing age with hyperprolactinemia: experience at a tertiary hospital
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2023
Anne Ongmeb Boli, Martine Claude Etoa Etoga, Francine Mekobe Mendane, Charly Feutseu, Eloumba Mbono Samba, Amazia Falmata, Arnaud Manga Ndi, Jean-Claude Katte, Mesmin Dehayem, Vicky Jocelyn Ama Moor, Jean Claude Mbanya, Eugène Sobngwi
Prolactin (PRL) is a single-chain protein synthesised and released by lactotroph cells of the anterior pituitary gland.1 Its secretion is regulated by dopamine, which has an inhibitory effect on lactotroph cells.1 When prolactin secretion increases in the absence of pregnancy, clinical symptoms such as galactorrhoea and irregular menstrual cycles may occur. These menstrual abnormalities include spaniomenorrhoea and amenorrhoea, which may contribute to infertility. Hyperprolactinemia is a well-recognised hormonal aetiology of infertility among women of childbearing age. It affects 30–40% of infertile women and 15–20% of women with menstrual disorders.2 Impairment of gonadal function and, ultimately, infertility result from suppression of the pulsatile secretion of gonadotrophins.3 The majority of prolactin molecules present as monomers that are biologically active, but these may also exist as macromolecules (macroPRL) known as big and big-big prolactin, which may interfere with laboratory measurements of the protein.4 According to Vilar et al., in 2019, two Brazilian series reported macroPRL as the third cause of non-physiological hyperprolactinemia after drugs and pituitary adenomas.5 All three forms of prolactin are indistinguishable by routine laboratory assays.
Serum androgens and prolactin levels in patients with keratoconus
Published in Clinical and Experimental Optometry, 2023
Hossein Jamali, Mojtaba Heydari, Nasrin Masihpour, Amir Khosravi, Mousa Zare, Mesbah Shams, Gholamhossein Ranjbar Omrani
Prolactin is a hormone produced and secreted by the pituitary gland. Its primary function in the body is considered to be the induction of breast growth and milk production during and after pregnancy. The significance of prolactin in the progression of keratoconus was hypothesised based on the fact of keratoconus progression in the pregnancy.36 Mckay et al.32 evaluated the effect of prolactin exposure on human corneal fibroblasts in normal and keratoconus cornea by measuring metabolite flux and enrichment pathways following treatment with prolactin. They observed a significant increase in nicotinamide metabolism, mitochondrial electron transport chain, and butyrate metabolism in normal cornea exposed to prolactin. In contrast, they observed no effect of prolactin on quinolinate and free amino acid flux in response to prolactin treatment.
Morphological features of the secretory phase endometrium in women with unexplained infertility
Published in Ultrastructural Pathology, 2021
Özdem Karaoğlan, Yurdun Kuyucu, İbrahim Ferhat Ürünsak, Derya Gümürdülü, Özgül Tap
In our study, baseline serum FSH, LH, TSH, and E2 values were measured on the second and third days of the menstrual cycle for determining ovarian reserve. Serum FSH, LH, and TSH values on fifth, sixth, and seventh days after ovulation showed no difference between the two groups, while prolactin levels were significantly higher in the infertile group. Increased serum prolactin levels, even if within physiological limits, have been noted in the literature to cause unexplained infertility via the proinflammatory effect.19 In accordance with these reports, in our study, the significant increase in prolactin serum levels in infertile women on the fifth and seventh days after ovulation, as well as the presence of macrophages and lymphocytes in the endometrial stroma, lead us to believe that the increased prolactin levels caused implantation failure in these patients through the proinflammatory effect. The higher prolactin levels in the infertile group, compared to the fertile group, may be due to intense stress experienced during pre-treatment and treatment. As a matter of fact, Csemiczky et al. reported that prolactin levels were increased in women during stressful situations.20