|Other names: Prolactin deficiency|
|Symptoms||Inability to produce milk after childbirth|
|Complications||Infertility, sexual dysfunction|
|Causes||Sheehan syndrome, pituitary surgery, traumatic brain injury, genetics|
|Diagnostic method||Blood tests|
|Treatment||Formula feeding the baby|
|Frequency||8 per 100,000 (Spain, 1999)|
Hypoprolactinemia is a medical condition characterized by a lack of prolactin, a hypothalamic-pituitary hormone. Symptoms include the inability to produce milk after childbirth. Usually it occurs together with hypopituitarism. Other complications may include infertility and sexual dysfunction.
Causes include Sheehan syndrome, pituitary surgery, traumatic brain injury, and certain genetic mutations. Diagnosis is by blood tests for prolactin, after being given thyrotropin. Confirming the diagnosis; however, is not necessarily required as there is no specific treatment.
While some evidence supports the use of recombinant human prolactin, it is not currently approved for medical use. Treatment generally involves formula feeding the baby. Prolactin deficiency alone is rare. It occurs in about 17% of cases of hypopituitarism or about 8 per 100,000 people in Spain as of 1999.
Signs and symptoms
Hypoprolactinemia is associated with ovarian dysfunction in women, and, in men, metabolic syndrome, anxiety, arteriogenic erectile dysfunction, premature ejaculation, low concentration of sperm, reduced sperm motility, hypofunction of seminal vesicles, and hypoandrogenism. In one study, normal sperm characteristics were restored when prolactin levels were brought up to normal values in men with hypoprolactinemia.
Hypoprolactinemia can result from autoimmune disease, hypopituitarism, growth hormone deficiency, hypothyroidism, excessive dopamine action in the tuberoinfundibular pathway and/or the anterior pituitary, and ingestion of drugs that activate the D2 receptor, such as direct D2 receptor agonists like bromocriptine and pergolide, and indirect D2 receptor activators like amphetamines (through the induction of dopamine release).
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 subfertility, treatment may include clomiphene citrate or gonadotropins.
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