prolactin

Last edited 07/2018

This is a hormone produced by the anterior pituitary gland. Prolactin is a polypeptide hormone composed of 199 amino acid residues.

Synthesis:

• synthesised by cells of the pituitary (lactotrophs)
• only small amounts of prolactin are stored in the pituitary gland

Release:

• under inhibitory dopaminergic control and stimulatory thyroid releasing hormone (TRH) control
• increased release at night
• in females - increased release during puberty
• androgens may have a modest inhibitory effect on release
• released in response to stress e.g. exercise
• prolactin levels are high during pregnancy - oestrogen causes an increase in numbers of lactotrophs
• during lactation, suckling of the breast results in an increased release of prolactin

Actions:

• breast - milk protein synthesis and excretion in ducts and lobules
• contraceptive effect - seen with high levels of prolactin
• has no established function in males

What level of prolactin is significant?(1)

• mildly increased prolactin levels (400-600mu/L) may be physiological and asymptomatic but higher levels are usually pathological
• very elevated levels (above 5,000mu/L) usually imply a prolactin-secreting pituitary tumour

Note that reference ranges vary between laboratories.

Notes:

• prolactin secretion varies with time, resulting in serum levels being 2-3 times higher at night than during the day. The levels of prolactin in normal individuals also tend to rise in response to physiological stimuli, including sleep, exercise, pregnancy and surgical stress (2)
• most patients with a prolactinoma are women

Reference:

• GPonline. Hyperprolactinaemia: diagnosis and management (Accessed July 28th 2018)
• South Tees Hospitals NHS Foundation Trust. Prolactin. (Accessed July 28th 2018)