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A prolactin modulator is a drug which affects the hypothalamic–pituitary–prolactin axis (HPP axis) by modulating the secretion of the pituitary hormone prolactin from the anterior pituitary gland. Prolactin inhibitors suppress and prolactin releasers induce the secretion of prolactin, respectively. [1] [2]
The magnitude that prolactin is elevated can be used as an indicator of the etiology of the hyperprolactinemia diagnosis. Prolactin levels over 250 ng/mL may suggest prolactinoma. Prolactin levels less than 100 ng/mL may suggest drug-induced hyperprolactinemia, macroprolactinemia, nonfunctioning pituitary adenomas, or systemic disorders.
Galactorrhea hyperprolactinemia is increased blood prolactin levels associated with galactorrhea (abnormal milk secretion). It may be caused by such things as certain medications, pituitary disorders and thyroid disorders. The condition can occur in males as well as females.
Changes in levels of certain hormones, such as prolactin or luteinizing hormone (LH) Mental health issues, such as depression, stress or anxiety Inflammation affecting the prostate gland or urethra
Hypoprolactinemia can result from autoimmune disease, [2] hypopituitarism, [1] growth hormone deficiency, [2] hypothyroidism, [2] excessive dopamine action in the tuberoinfundibular pathway and/or the anterior pituitary, and ingestion of drugs that activate the D 2 receptor, such as direct D 2 receptor agonists like bromocriptine and pergolide, and indirect D 2 receptor activators like ...
Dopamine is the chemical that normally inhibits prolactin secretion, so clinicians may treat prolactinoma with drugs that act like dopamine such as bromocriptine and cabergoline. [12] This type of drug is called a dopamine agonist. [12] These drugs shrink the tumor and return prolactin levels to normal in approximately 80% of patients.
The increase in prolactin levels observed with the two drugs was much greater in women than in men. [74] [75] This appears to be due to the higher estrogen levels in women, as estrogen stimulates prolactin secretion from the pituitary gland. [76]
Prolactin has a wide variety of effects. It stimulates the mammary glands to produce milk (): increased serum concentrations of prolactin during pregnancy cause enlargement of the mammary glands and prepare for milk production, which normally starts when levels of progesterone fall by the end of pregnancy and a suckling stimulus is present.