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Prolactin and human reproduction.

A brief research review of prolactin and human reproduction is presented. McNatty et al. concluded that high prolactin concentrations in the early follicular stage inhibit progesterone secretion and lower levels in the luteal phase act permissively to enhance progesterone secretion. Patients with hyperprolactinemia and amenorrhea and occasional patients with oligomenorrhea will respond to treatment with Bromocriptine with a return of menses suggesting that the anovulatory or amenorrheic state is a prolactin-dependent condition. Bohnet et al. found that patients with long-standing hyperprolactinemia (more than 4 months) displayed no episodic secretion of luteinizing hormone (LH). Treatment of these patients with Bromocriptine lowered serum prolactin to the normal range and episodic secretion was then seen. Prolactin appears to act at 2 loci to interfer with normal events associated with the menstrual cycle: 1) by blocking the hypothalamic mechanism responsible for the episodic secretion of LH and 2) inhibiting the positive feedback of estrogen on LH secretion. It is suggested that hyperprolactinemia may be the mechanism leading to the increased anovulatory period in women who breast-feed since five-to tenfold increases of prolactin concentrations occur within 30 minutes of the onset of each episode of suckling. These increases directly or indirectly inhibit the normal hypothalamic pituitary mechanism responsible for the midcycle LH surge. In males with hyperprolactimenia Bromocriptine also appears to be effective in lowering serum prolactin followed by an increase in serum testosterone and a return of libido and potency.