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When symptoms are present, medical therapy is the treatment of choice. Patients with hyperprolactinemia and no symptoms (idiopathic or microprolactinoma) can be monitored without treatment. Consider treatment for women with amenorrhea. In addition, dual energy X-ray absorptiometry scanning should be considered to evaluate bone density.
Only during nipple stimulation will prolactin levels rise, allowing for milk production. [22] At 6 weeks post-birth (postpartum), estradiol concentrations decrease, and prolactin concentrations return to normal even during breastfeeding. Fluctuations in prolactin levels during menstrual cycles and menopause are inconclusive. [23]
Lactation requires the presence of prolactin, and the evaluation of galactorrhea includes eliciting a history for various medications or foods (methyldopa, opioids, antipsychotics, serotonin reuptake inhibitors [4]) and for behavioral causes (stress, breast, and chest wall stimulation), as well as evaluation for gestation, pituitary adenomas ...
Although neonatal weight loss is a normal physiological process where the infant excretes extra extracellular fluids accumulated pre-birth, it typically should not exceed 10% of birth weight. [7] With delayed OL, excessive weight loss is likely to be an indication and result of ineffective milk transfer, which can subsequently lead to reduced ...
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.
There are few treatments which increase prolactin levels in humans. Treatment differs based on the reason for diagnosis. Women who are diagnosed with hypoprolactinemia following lactation failure are typically advised to formula feed, although treatment with metoclopramide has been shown to increase milk supply in clinical studies. For ...
Mechanical detection of suckling increases prolactin levels in the body to increase milk synthesis. Excess prolactin may inhibit the menstrual cycle directly, by a suppressive effect on the ovary, or indirectly, by decreasing the release of GnRH. [2] Suckling is a pivotal factor in maintaining lactational amenorrhea postpartum.
After childbirth, the tuberoinfundibular pathway resumes its role in regulating prolactin levels. The decline in estrogen levels postpartum contributes to the restoration of dopaminergic inhibition, preventing sustained hyperprolactinemia in non-pregnant and non-nursing individuals.