Shannon and Chris sell magazines to raise money for their

Prolactin and Galactorrhea Prolactin is secreted by the anterior pituitary gland with release being controlled by a wide variety of physiological factors. Dopamine acts as the primary prolactin releasing inhibitory factor and hence dopamine agonists such as bromocriptine may be used to control galactorrhoea. It is important to differentiate the causes of galactorrhoea (due to the actions of prolactin on breast tissue) from those of gynaecomastia. Features of excess prolactin  men: impotence, loss of libido, galactorrhoea  women: amenorrhoea, galactorrhoea Causes of raised prolactin ­ the p's  pregnancy  prolactinoma  physiological  polycystic ovarian syndrome  primary hypothyroidism  phenothiazines, metoclopramide, domperidone Causes of raised prolactin  prolactinoma  pregnancy  oestrogens  physiological: stress, exercise, sleep  acromegaly: 1/3 of patients  polycystic ovarian syndrome  primary hypothyroidism (due to thyrotrophin releasing hormone (TRH) stimulating prolactin release) Drug causes of raised prolactin  metoclopramide, domperidone  phenothiazines  haloperidol  very rare: SSRIs, opioids