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Prolactin Deficiency Treatment & Management

  • Author: Charles T Benson, MD, PhD; Chief Editor: George T Griffing, MD  more...
Updated: Jun 10, 2014

Medical Care

Generally, formula and/or bottle-feeding of infants are recommended for women with puerperal hypoprolactinemia and insufficient milk supply. Drugs to increase milk output generally are not effective.



Consult an endocrinologist.

Contributor Information and Disclosures

Charles T Benson, MD, PhD Medical Fellow, Eli Lilly and Company, UK

Disclosure: Received salary from Eli Lilly & Co for employment.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Yoram Shenker, MD Chief of Endocrinology Section, Veterans Affairs Medical Center of Madison; Interim Chief, Associate Professor, Department of Internal Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Wisconsin at Madison

Yoram Shenker, MD is a member of the following medical societies: American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society

Disclosure: Nothing to disclose.

Additional Contributors

Frederick H Ziel, MD Associate Professor of Medicine, University of California, Los Angeles, David Geffen School of Medicine; Physician-In-Charge, Endocrinology/Diabetes Center, Director of Medical Education, Kaiser Permanente Woodland Hills; Chair of Endocrinology, Co-Chair of Diabetes Complete Care Program, Southern California Permanente Medical Group

Frederick H Ziel, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Endocrinology, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, American Federation for Medical Research, American Medical Association, American Society for Bone and Mineral Research, California Medical Association, Endocrine Society, International Society for Clinical Densitometry

Disclosure: Nothing to disclose.

  1. Cosman F, Post KD, Holub DA, et al. Lymphocytic hypophysitis. Report of 3 new cases and review of the literature. Medicine (Baltimore). 1989 Jul. 68(4):240-56. [Medline].

  2. Thodou E, Asa SL, Kontogeorgos G, et al. Clinical case seminar: lymphocytic hypophysitis: clinicopathological findings. J Clin Endocrinol Metab. 1995 Aug. 80(8):2302-11. [Medline]. [Full Text].

  3. Toledano Y, Lubetsky A, Shimon I. Acquired prolactin deficiency in patients with disorders of the hypothalamic-pituitary axis. J Endocrinol Invest. 2007 Apr. 30(4):268-73. [Medline].

  4. Zargar AH, Masoodi SR, Laway BA, et al. Familial puerperal alactogenesis: possibility of a genetically transmitted isolated prolactin deficiency. Br J Obstet Gynaecol. 1997 May. 104(5):629-31. [Medline].

  5. Falk RJ. Isolated prolactin deficiency: a case report. Fertil Steril. 1992 Nov. 58(5):1060-2. [Medline].

  6. Kauppila A, Chatelain P, Kirkinen P, et al. Isolated prolactin deficiency in a woman with puerperal alactogenesis. J Clin Endocrinol Metab. 1987 Feb. 64(2):309-12. [Medline].

  7. Swaminathan G, Varghese B, Thangavel C, et al. Prolactin stimulates ubiquitination, initial internalization, and degradation of its receptor via catalytic activation of Janus kinase 2. J Endocrinol. 2008 Feb. 196(2):R1-7. [Medline].

  8. Oseko F, Nakano A, Morikawa K, et al. Effects of chronic bromocriptine-induced hypoprolactinemia on plasma testosterone responses to human chorionic gonadotropin stimulation in normal men. Fertil Steril. 1991 Feb. 55(2):355-7. [Medline].

  9. Russell DH, Kibler R, Matrisian L, et al. Prolactin receptors on human T and B lymphocytes: antagonism of prolactin binding by cyclosporine. J Immunol. 1985 May. 134(5):3027-31. [Medline].

  10. Bernton EW, Meltzer MS, Holaday JW. Suppression of macrophage activation and T-lymphocyte function in hypoprolactinemic mice. Science. 1988 Jan 22. 239(4838):401-4. [Medline].

  11. Carrier M, Wild J, Pelletier LC, et al. Bromocriptine as an adjuvant to cyclosporine immunosuppression after heart transplantation. Ann Thorac Surg. 1990 Jan. 49(1):129-32. [Medline].

  12. Palestine AG, Nussenblatt RB, Gelato M. Therapy for human autoimmune uveitis with low-dose cyclosporine plus bromocriptine. Transplant Proc. 1988 Jun. 20(3 Suppl 4):131-5. [Medline].

  13. Lucas A, Baker BA, Cole TJ. Plasma prolactin and clinical outcome in preterm infants. Arch Dis Child. 1990 Sep. 65(9):977-83. [Medline]. [Full Text].

  14. Bonomo IT, Lisboa PC, Pereira AR, et al. Prolactin inhibition in dams during lactation programs for overweight and leptin resistance in adult offspring. J Endocrinol. 2007 Feb. 192(2):339-44. [Medline].

  15. Laway BA, Mir SA, Gojwari T, Shah TR, Zargar AH. Selective preservation of anterior pituitary functions in patients with Sheehan's syndrome. Indian J Endocrinol Metab. 2011 Sep. 15 Suppl 3:S238-41. [Medline]. [Full Text].

  16. Shivaprasad C. Sheehan's syndrome: Newer advances. Indian J Endocrinol Metab. 2011 Sep. 15 Suppl 3:S203-7. [Medline]. [Full Text].

  17. Leng L, Zhang Y. Effects of an estrogen receptor antagonist on proliferation, prolactin secretion and growth factor expression in the MMQ pituitary prolactinoma cell line. J Clin Neurosci. 2011 Oct 18. [Medline].

  18. Fofanova O, Takamura N, Kinoshita E, et al. Compound heterozygous deletion of the PROP-1 gene in children with combined pituitary hormone deficiency. J Clin Endocrinol Metab. 1998 Jul. 83(7):2601-4. [Medline]. [Full Text].

  19. Rosenbloom AL, Almonte AS, Brown MR, et al. Clinical and biochemical phenotype of familial anterior hypopituitarism from mutation of the PROP1 gene. J Clin Endocrinol Metab. 1999 Jan. 84(1):50-7. [Medline]. [Full Text].

  20. Yang H, Dixit VD, Patel K, et al. Reduction in hypophyseal growth hormone and prolactin expression due to deficiency in ghrelin receptor signaling is associated with Pit-1 suppression: relevance to the immune system. Brain Behav Immun. 2008 Jun 17. [Medline].

  21. Samuels MH, Henry P, Kleinschmidt-Demasters B, et al. Pulsatile prolactin secretion in hyperprolactinemia due to presumed pituitary stalk interruption. J Clin Endocrinol Metab. 1991 Dec. 73(6):1289-93. [Medline].

  22. Diaz S, Seron-Ferre M, Cardenas H, et al. Circadian variation of basal plasma prolactin, prolactin response to suckling, and length of amenorrhea in nursing women. J Clin Endocrinol Metab. 1989 May. 68(5):946-55. [Medline].

  23. Stawerska R, Lewinski A, Smyczynska J, et al. Circadian pattern of prolactin secretion in children with growth hormone deficiency and congenital organic lesions in the hypothalamic-pituitary region. Neuro Endocrinol Lett. 2007 Dec. 28(6):765-74. [Medline].

  24. Ehrenkranz RA, Ackerman BA. Metoclopramide effect on faltering milk production by mothers of premature infants. Pediatrics. 1986 Oct. 78(4):614-20. [Medline].

  25. Gupta AP, Gupta PK. Metoclopramide as a lactogogue. Clin Pediatr (Phila). 1985 May. 24(5):269-72. [Medline].

  26. Kauppila A, Anunti P, Kivinen S, et al. Metoclopramide and breast feeding: efficacy and anterior pituitary responses of the mother and the child. Eur J Obstet Gynecol Reprod Biol. 1985 Jan. 19(1):19-22. [Medline].

  27. Kauppila A, Kivinen S, Ylikorkala O. A dose response relation between improved lactation and metoclopramide. Lancet. 1981 May 30. 1(8231):1175-7. [Medline].

  28. Kauppila A, Kivinen S, Ylikorkala O. Metoclopramide increases prolactin release and milk secretion in puerperium without stimulating the secretion of thyrotropin and thyroid hormones. J Clin Endocrinol Metab. 1981 Mar. 52(3):436-9. [Medline].

  29. Sousa PL. Letter: Metoclopramide and breast-feeding. Br Med J. 1975 Mar 1. 1(5956):512. [Medline]. [Full Text].

  30. Andersen AN, Lund-Andersen C, Larsen JF, et al. Suppressed prolactin but normal neurophysin levels in cigarette smoking breast-feeding women. Clin Endocrinol (Oxf). 1982 Oct. 17(4):363-8. [Medline].

  31. Carlson HE, Brickman AS, Bottazzo GF. Prolactin deficiency in pseudohypoparathyroidism. N Engl J Med. 1977 Jan 20. 296(3):140-4. [Medline].

  32. Clevenger CV, Altmann SW, Prystowsky MB. Requirement of nuclear prolactin for interleukin-2--stimulated proliferation of T lymphocytes. Science. 1991 Jul 5. 253(5015):77-9. [Medline].

  33. Devins SS, Miller A, Herndon BL, et al. Effects of dopamine on T-lymphocyte proliferative responses and serum prolactin concentrations in critically ill patients. Crit Care Med. 1992 Dec. 20(12):1644-9. [Medline].

  34. Doty RL, Fernandez AD, Levine MA, et al. Olfactory dysfunction in type I pseudohypoparathyroidism: dissociation from Gs alpha protein deficiency. J Clin Endocrinol Metab. 1997 Jan. 82(1):247-50. [Medline]. [Full Text].

  35. Du Ruisseau P, Taché Y, Brazeau P, et al. Effects of chronic immobilization stress on pituitary hormone secretion, on hypothalamic factor levels, and on pituitary responsiveness to LHRH and TRH in female rats. Neuroendocrinology. 1979. 29(2):90-9. [Medline].

  36. Gonzales GF, Velasquez G, Garcia-Hjarles M. Hypoprolactinemia as related to seminal quality and serum testosterone. Arch Androl. 1989. 23(3):259-65. [Medline].

  37. Hypoprolactinaemia. Lancet. 1987 Jun 13. 1(8546):1356-7. [Medline].

  38. Kauppila A. Isolated prolactin deficiency. Curr Ther Endocrinol Metab. 1997. 6:31-3. [Medline].

  39. Lopez-Calderon A, Ariznavarreta C, Calderon MD, et al. Role of the adrenal cortex in chronic stress-induced inhibition of prolactin secretion in male rats. J Endocrinol. 1989 Feb. 120(2):269-73. [Medline].

  40. Mukherjee A, Murray RD, Columb B, Gleeson HK, Shalet SM. Acquired prolactin deficiency indicates severe hypopituitarism in patients with disease of the hypothalamic-pituitary axis. Clin Endocrinol (Oxf). 2003 Dec. 59(6):743-8. [Medline].

  41. Murphy WJ, Rui H, Longo DL. Effects of growth hormone and prolactin immune development and function. Life Sci. 1995. 57(1):1-14. [Medline].

  42. Oda T, Yoshimura Y, Takehara Y, et al. Effects of prolactin on fertilization and cleavage of human oocytes. Horm Res. 1991. 35 Suppl 1:33-8. [Medline].

  43. Ozbey N, Inanc S, Aral F, et al. Clinical and laboratory evaluation of 40 patients with Sheehan's syndrome. Isr J Med Sci. 1994 Nov. 30(11):826-9. [Medline].

  44. Parks JS, Abdul-Latif H, Kinoshita E, et al. Genetics of growth hormone gene expression. Horm Res. 1993. 40(1-3):54-61. [Medline].

  45. Peters F, Schulze-Tollert J, Schuth W. Thyrotrophin-releasing hormone--a lactation-promoting agent?. Br J Obstet Gynaecol. 1991 Sep. 98(9):880-5. [Medline].

  46. Poindexter AN, Buttram VC, Besch PK, et al. Circulating prolactin levels. I. Normal females. Int J Fertil. 1977. 22(1):1-5. [Medline].

  47. Pullano JG, Cohen-Addad N, Apuzzio JJ, et al. Water and salt conservation in the human fetus and newborn. I. Evidence for a role of fetal prolactin. J Clin Endocrinol Metab. 1989 Dec. 69(6):1180-6. [Medline].

  48. Rigg LA, Lein A, Yen SS. Pattern of increase in circulating prolactin levels during human gestation. Am J Obstet Gynecol. 1977 Oct 15. 129(4):454-6. [Medline].

  49. Russell DH. New aspects of prolactin and immunity: a lymphocyte-derived prolactin-like product and nuclear protein kinase C activation. Trends Pharmacol Sci. 1989 Jan. 10(1):40-4. [Medline].

  50. Russell DH, Larson DF, Cardon SB, et al. Cyclosporine inhibits prolactin induction of ornithine decarboxylase in rat tissues. Mol Cell Endocrinol. 1984 May. 35(2-3):159-66. [Medline].

  51. Seibel MM, Smith D, Dlugi AM, et al. Periovulatory follicular fluid hormone levels in spontaneous human cycles. J Clin Endocrinol Metab. 1989 Jun. 68(6):1073-7. [Medline].

  52. Sheehan HL. The recognition of chronic hypopituitarism resulting from postpartum pituitary necrosis. Am J Obstet Gynecol. 1971 Nov. 111(6):852-4. [Medline].

  53. Tucker HA. Endocrinology of lactation. Semin Perinatol. 1979 Jul. 3(3):199-223. [Medline].

  54. Turkington RW. Phenothiazine stimulation test for prolactin reserve: the syndrome of isolated prolactin deficiency. J Clin Endocrinol Metab. 1972 Jan. 34(1):246-9. [Medline].

  55. Tyson JE, Perez A, Zanartu J. Human lactational response to oral thyrotropin releasing hormone. J Clin Endocrinol Metab. 1976 Oct. 43(4):760-8. [Medline].

  56. Weinstein LS, Liu J, Sakamoto A, et al. Minireview: GNAS: normal and abnormal functions. Endocrinology. 2004 Dec. 145(12):5459-64. [Medline]. [Full Text].

  57. Wettschureck N, Offermanns S. Mammalian G proteins and their cell type specific functions. Physiol Rev. 2005 Oct. 85(4):1159-204. [Medline]. [Full Text].

  58. Yazigi RA, Quintero CH, Salameh WA. Prolactin disorders. Fertil Steril. 1997 Feb. 67(2):215-25. [Medline].

  59. Ylikorkala O, Kivinen S, Kauppila A. Oral administration of TRH in puerperal women: effect on insufficient lactation, thyroid hormones and on the responses of TSH and prolactin to intravenous TRH. Acta Endocrinol (Copenh). 1980 Apr. 93(4):413-8. [Medline].

  60. Yoneda N, Irahara M, Saito S, et al. Usefulness of recombinant human prolactin for treatment of poor puerperal lactation in a rat model. Eur J Endocrinol. 1995 Nov. 133(5):613-7. [Medline].

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