Prolactin

Prolactin (PRL), also known as luteotropic

PRL
hormone or luteotropin, is a protein best known
for its role in enabling Mammals (and Birds), Available structures
usually females, to produce milk. It is influential PDB Ortholog search: PDBe (https://www.ebi.ac.uk/pdbe/sear
in over 300 separate processes in various chResults.html?display=both&term=P06879%20or%20P
vertebrates, including humans.[5] Prolactin is 01236) RCSB (http://www.rcsb.org/pdb/search/smartSub
secreted from the pituitary gland in response to query.do?smartSearchSubtype=UpAccessionIdQuery&ac
eating, mating, estrogen treatment, ovulation and cessionIdList=P06879,P01236)
nursing. It is secreted heavily in pulses in between
List of PDB id codes
these events. Prolactin plays an essential role in
metabolism, regulation of the immune system and 1RW5 (https://www.rcsb.org/structure/1RW5), 2Q98 (https://
pancreatic development. www.rcsb.org/structure/2Q98), 3D48 (https://www.rcsb.org/s
tructure/3D48), 3EW3 (https://www.rcsb.org/structure/3EW
Discovered in non-human animals around 1930
3), 3MZG (https://www.rcsb.org/structure/3MZG), 3N06 (http
by Oscar Riddle[6] and confirmed in humans in
s://www.rcsb.org/structure/3N06), 3N0P (https://www.rcsb.or
1970 by Henry Friesen,[7] prolactin is a peptide
g/structure/3N0P), 3NCB (https://www.rcsb.org/structure/3N
hormone, encoded by the PRL gene.[8]
CB), 3NCC (https://www.rcsb.org/structure/3NCC), 3NCE (h
In mammals, prolactin is associated with milk ttps://www.rcsb.org/structure/3NCE), 3NCF (https://www.rcs
production; in fish it is thought to be related to the b.org/structure/3NCF), 3NPZ (https://www.rcsb.org/structur
control of water and salt balance. Prolactin also e/3NPZ)
acts in a cytokine-like manner and as an important
regulator of the immune system. It has important Identifiers
cell cycle-related functions as a growth-, Aliases PRL (https://www.genenames.org/cgi-bin/gene_symbol
differentiating- and anti-apoptotic factor. As a _report?hgnc_id=9445), GHA1, prolactin
growth factor, binding to cytokine-like receptors,
External OMIM: 176760 (https://omim.org/entry/176760) MGI:
it influences hematopoiesis and angiogenesis, and
IDs 97762 (http://www.informatics.jax.org/marker/MGI:977
is involved in the regulation of blood clotting
62) HomoloGene: 732 (https://www.ncbi.nlm.nih.gov/e
through several pathways. The hormone acts in
ntrez/query.fcgi?cmd=Retrieve&db=homologene&dopt
endocrine, autocrine and paracrine manner
=HomoloGene&list_uids=732) GeneCards: PRL (http
through the prolactin receptor and numerous
s://www.genecards.org/cgi-bin/carddisp.pl?gene=PRL)
cytokine receptors.[5]
Gene location (Human)
Pituitary prolactin secretion is regulated by
endocrine neurons in the hypothalamus. The most
important of these are the neurosecretory
tuberoinfundibulum (TIDA) neurons of the
arcuate nucleus that secrete dopamine (aka
Prolactin Inhibitory Hormone) to act on the D2
receptors of lactotrophs, causing inhibition of Chr. Chromosome 6 (human)[1]
prolactin secretion. Thyrotropin-releasing factor
(thyrotropin-releasing hormone) has a stimulatory
effect on prolactin release, however prolactin is
the only adenohypophyseal hormone whose
Band 6p22.3 Start 22,287,244 bp[1]
principal control is inhibitory.
Several variants and forms are known per species. End 22,302,826 bp[1]
Many fish have variants prolactin A and prolactin
Gene location (Mouse)
B. Most vertebrates including humans also have
the closely related somatolactin. In humans, three
smaller (4, 16 and 22 kDa) and several larger (so
called big and big-big) variants exist.

Contents Chr. Chromosome 13 (mouse)[2]

Functions
Functions in other vertebrate
species
Regulation Band 13 A3.1|13 12.25 cM Start 27,057,570 bp[2]

Structure and isoforms End 27,065,205 bp[2]

Prolactin receptor
Diagnostic use
Units and unit conversions
Reference ranges
Inter-method variability
Conditions
Elevated levels
Decreased levels
In medicine
See also
References
External links
Functions
Prolactin has a wide variety of effects. It
stimulates the mammary glands to produce milk
(lactation): increased serum concentrations of
prolactin during pregnancy cause enlargement of
the mammary glands and prepare for milk
production, which normally starts when levels of
progesterone fall by the end of pregnancy and a
suckling stimulus is present. Prolactin plays an
important role in maternal behavior.[9]
In general, dopamine inhibits prolactin[10] but this
process has feedback mechanisms.[11]
Elevated levels of prolactin decrease the levels of
sex hormones — estrogen in women and
testosterone in men.[12] The effects of mildly
elevated levels of prolactin are much more
variable, in women, substantially increasing or
decreasing estrogen levels.
Gene ontology
Molecular • prolactin receptor binding (http://amigo.geneontolo
function gy.org/amigo/term/GO:0005148)
• protein binding (http://amigo.geneontology.org/ami
go/term/GO:0005515)
• hormone activity (http://amigo.geneontology.org/a
migo/term/GO:0005179)
Cellular • extracellular region (http://amigo.geneontology.or
component g/amigo/term/GO:0005576)
• endosome lumen (http://amigo.geneontology.org/a
migo/term/GO:0031904)
• secretory granule (http://amigo.geneontology.org/a
migo/term/GO:0030141)
• extracellular space (http://amigo.geneontology.or
g/amigo/term/GO:0005615)
Biological • female pregnancy (http://amigo.geneontology.org/
process amigo/term/GO:0007565)
• cellular protein metabolic process (http://amigo.ge
neontology.org/amigo/term/GO:0044267)
• cell surface receptor signaling pathway (http://ami
go.geneontology.org/amigo/term/GO:0007166)
• JAK-STAT cascade involved in growth hormone
signaling pathway (http://amigo.geneontology.org/a
migo/term/GO:0060397)
• lactation (http://amigo.geneontology.org/amigo/ter
m/GO:0007595)
• cell proliferation (http://amigo.geneontology.org/a
migo/term/GO:0008283)
• positive regulation of JAK-STAT cascade (http://a
migo.geneontology.org/amigo/term/GO:0046427)
• regulation of multicellular organism growth (http://
amigo.geneontology.org/amigo/term/GO:0040014)
Prolactin is sometimes classified as
gonadotropin[13] although in humans it has only a
weak luteotropic effect while the effect of
suppressing classical gonadotropic hormones is
more important.[14] Prolactin within the normal
reference ranges can act as a weak gonadotropin,
but at the same time suppresses GnRH secretion.
The exact mechanism by which it inhibits GnRH
is poorly understood. Although expression of
prolactin receptors (PRL-R) have
demonstrated in rat hypothalamus, the same has
not been observed in GnRH neurons.[15]
Physiologic levels of prolactin in males enhance
luteinizing hormone-receptors in Leydig cells,
resulting in testosterone secretion, which leads to
spermatogenesis.[16]
Prolactin also stimulates proliferation
oligodendrocyte precursor cells. These cells
differentiate into oligodendrocytes, the cells
responsible for the formation of myelin coatings
on axons in the central nervous system.[17]
Other actions include contributing to pulmonary
surfactant synthesis of the fetal lungs at the end of
the pregnancy and immune tolerance of the fetus
by the maternal organism during pregnancy.
Prolactin promotes neurogenesis in maternal and
fetal brains.[18][19]
Functions in other vertebrate
species
The primary function of prolactin in fish is
osmoregulation,[20] i.e., controlling the movement
of water and salts between the tissues of the fish
and the surrounding water. Like mammals,
however, prolactin in fish also has reproductive
functions, including promoting sexual maturation
and inducing breeding cycles, as well as brooding
and parental care.[21] In the South American
discus, prolactin may also regulate the production
of a skin secretion that provides food for larval
fry.[22] An increase in brooding behaviour caused
by prolactin has been reported in hens.[23]
Prolactin and its receptor are expressed in the
skin, specifically in the hair follicles, where they
regulate hair growth and moulting in an autocrine
fashion.[24][25] Elevated levels of prolactin can
a • regulation of receptor activity (http://amigo.geneon
tology.org/amigo/term/GO:0010469)
• negative regulation of endothelial cell proliferation
(http://amigo.geneontology.org/amigo/term/GO:000
1937)
• negative regulation of angiogenesis (http://amigo.
geneontology.org/amigo/term/GO:0016525)
• positive regulation of pri-miRNA transcription from
RNA polymerase II promoter (http://amigo.geneonto
been logy.org/amigo/term/GO:1902895)
• childbirth
• response to nutrient (http://amigo.geneontology.or
g/amigo/term/GO:0007584)
• circadian rhythm (http://amigo.geneontology.org/a
migo/term/GO:0007623)
• positive regulation of cell proliferation (http://amig
of o.geneontology.org/amigo/term/GO:0008284)
• response to organic cyclic compound (http://amig
o.geneontology.org/amigo/term/GO:0014070)
• regulation of ossification (http://amigo.geneontolog
y.org/amigo/term/GO:0030278)
• response to estradiol (http://amigo.geneontology.o
rg/amigo/term/GO:0032355)
• response to lipopolysaccharide (http://amigo.gene
ontology.org/amigo/term/GO:0032496)
• cellular response to hormone stimulus (http://amig
o.geneontology.org/amigo/term/GO:0032870)
• multicellular organismal response to stress (http://
amigo.geneontology.org/amigo/term/GO:0033555)
• response to drug (http://amigo.geneontology.org/a
migo/term/GO:0042493)
• ovulation cycle (http://amigo.geneontology.org/ami
go/term/GO:0042698)
• response to ethanol (http://amigo.geneontology.or
g/amigo/term/GO:0045471)
• positive regulation of epithelial cell proliferation (ht
tp://amigo.geneontology.org/amigo/term/GO:005067
9)
• mammary gland development (http://amigo.geneo
ntology.org/amigo/term/GO:0030879)
• response to nutrient levels (http://amigo.geneontol
ogy.org/amigo/term/GO:0031667)
• positive regulation of lactation (http://amigo.geneo
ntology.org/amigo/term/GO:1903489)
Sources:Amigo (http://amigo.geneontology.org/) / QuickGO (http
s://www.ebi.ac.uk/QuickGO/)
Orthologs
inhibit hair growth,[26] and knock-out mutations Species Human Mouse
in the prolactin gene cause increased hair length Entrez
in cattle[27] and mice.[25] Conversely, mutations 5617 (https://www.ncbi.nlm. 19109 (https://www.ncbi.nl
in the prolactin receptor can cause reduced hair nih.gov/entrez/query.fcgi?d m.nih.gov/entrez/query.fcg
growth, resulting in the "slick" phenotype in b=gene&cmd=retrieve&dop i?db=gene&cmd=retrieve&
cattle.[27][28] Additionally, prolactin delays hair t=default&list_uids=5617&r dopt=default&list_uids=191
regrowth in mice.[29] n=1) 09&rn=1)

Analogous to its effects on hair growth and Ensembl

shedding in mammals, prolactin in birds controls ENSG00000172179 (http:// ENSMUSG00000021342
the moulting of feathers,[30] as well as the age at www.ensembl.org/Homo_s (http://www.ensembl.org/M
onset of feathering in both turkeys and apiens/geneview?gene=EN us_musculus/geneview?ge
chickens.[31] SG00000172179;db=core) ne=ENSMUSG000000213
42;db=core)

Regulation UniProt
P01236 (https://www.unipro P06879 (https://www.unipro
In humans, prolactin is produced at least in the
t.org/uniprot/P01236) t.org/uniprot/P06879)
anterior pituitary, decidua, myometrium, breast,
lymphocytes, leukocytes and prostate.[32][33]
RefSeq
NM_000948 (https://www.n NM_001163530 (https://ww
Pituitary PRL is controlled by the Pit-1 (mRNA)
cbi.nlm.nih.gov/entrez/view w.ncbi.nlm.nih.gov/entrez/vi
transcription factor that binds to the prolactin
er.fcgi?val=NM_000948) ewer.fcgi?val=NM_001163
gene at several sites. Ultimately dopamine,
NM_001163558 (https://ww 530)
extrapituitary PRL is controlled by a superdistal
w.ncbi.nlm.nih.gov/entrez/vi NM_011164 (https://www.n
promoter and apparently unaffected by
ewer.fcgi?val=NM_001163 cbi.nlm.nih.gov/entrez/view
dopamine.[33] The thyrotropin-releasing hormone
558) er.fcgi?val=NM_011164)
and the vasoactive intestinal peptide stimulate the
secretion of prolactin in experimental settings,
RefSeq
however their physiological influence is unclear. NP_000939 (https://www.n NP_001157002 (https://ww
(protein)
The main stimulus for prolactin secretion is cbi.nlm.nih.gov/entrez/view w.ncbi.nlm.nih.gov/entrez/vi
suckling, the effect of which is neuronally er.fcgi?val=NP_000939) ewer.fcgi?val=NP_0011570
mediated.[34] A key regulator of prolactin NP_001157030 (https://ww 02)
production is estrogens that enhance growth of w.ncbi.nlm.nih.gov/entrez/vi NP_035294 (https://www.n
prolactin-producing cells and stimulate prolactin ewer.fcgi?val=NP_0011570 cbi.nlm.nih.gov/entrez/view
production directly, as well as suppressing 30) er.fcgi?val=NP_035294)
dopamine.
Location Chr 6: 22.29 – 22.3 Mb (ht Chr 13: 27.06 – 27.07 Mb
In decidual cells and in lymphocytes the distal
(UCSC) tps://genome.ucsc.edu/cgi (https://genome.ucsc.edu/
promoter and thus prolactin expression is
-bin/hgTracks?org=Human cgi-bin/hgTracks?org=Mou
stimulated by cAMP. Responsivness to cAMP is
&db=hg38&position=chr6: se&db=mm0&position=chr
mediated by an imperfect cAMP–responsive
22287244-22302826) 13:27057570-27065205)
element and two CAAT/enhancer binding proteins
PubMed [3] [4]
(C/EBP).[33] Progesterone upregulates prolactin
search
synthesis in the endometrium and decreases it in
myometrium and breast glandular tissue.[35] Wikidata

Breast and other tissues may express the Pit-1 View/Edit Human View/Edit Mouse
promoter in addition to the distal promoter.
Extrapituitary production of prolactin is thought to be special to humans and primates and may serve mostly tissue-specific paracrine
and autocrine purposes. It has been hypothesized that in vertebrates such as mice a similar tissue-specific effect is achieved by a large
family of prolactin-like proteins controlled by at least 26 paralogous PRL genes not present in primates.[33]

Vasoactive intestinal peptide and peptide histidine isoleucine help to regulate prolactin secretion in humans, but the functions of these
hormones in birds can be quite different.[36]

Prolactin follows diurnal and ovulatory cycles. Prolactin levels peak during REM sleep and in the early morning. Many mammals
experience a seasonal cycle.

During pregnancy, high circulating concentrations of estrogen and progesterone increase prolactin levels by 10- to 20-fold. Estrogen
and progesterone inhibit the stimulatory effects of prolactin on milk production. The abrupt drop of estrogen and progesterone levels
following delivery allow prolactin—which temporarily remains high—to induce lactation.

Sucking on the nipple offsets the fall in prolactin as the internal stimulus for them is removed. The sucking activates
mechanoreceptors in and around the nipple. These signals are carried by nerve fibers through the spinal cord to the hypothalamus,
where changes in the electrical activity of neurons that regulate the pituitary gland increase prolactin secretion. The suckling stimulus
also triggers the release of oxytocin from the posterior pituitary gland, which triggers milk let-down: Prolactin controls milk
production (lactogenesis) but not the milk-ejection reflex; the rise in prolactin fills the breast with milk in preparation for the next
feed.

In usual circumstances, in the absence of galactorrhea, lactation ceases within one or two weeks following the end of breastfeeding.

Levels can rise after exercise, high-protein meals, minor surgical procedures,[37] following epileptic seizures[38] or due to physical or
emotional stress.[39][40] In a study on female volunteers under hypnosis, prolactin surges resulted from the evocation, with rage, of
humiliating experiences, but not from the fantasy of nursing.[40]

Hypersecretion is more common than hyposecretion. Hyperprolactinemia is the most frequent abnormality of the anterior pituitary
tumors, termed prolactinomas. Prolactinomas may disrupt the hypothalamic-pituitary-gonadal axis as prolactin tends to suppress the
secretion of GnRH from the hypothalamus and in turn decreases the secretion of follicle-stimulating hormone (FSH) and luteinizing
hormone (LH) from the anterior pituitary, therefore disrupting the ovulatory cycle.[41] Such hormonal changes may manifest as
amenorrhea and infertility in females as well as impotence in males. Inappropriate lactation (galactorrhoea) is another important
clinical sign of prolactinomas.

Structure and isoforms

The structure of prolactin is similar to that of growth hormone and placental lactogen. The molecule is folded due to the activity of
three disulfide bonds. Significant heterogeneity of the molecule has been described, thus bioassays and immunoassays can give
different results due to differing glycosylation, phosphorylation and sulfation, as well as degradation. The non-glycosylated form of
prolactin is the dominant form that is secreted by the pituitary gland.

The three different sizes of prolactin are:

Little prolactin—the predominant form.[42] It has a molecular weight of appxoximately 22-kDa.[42] It is a single-chain
polypeptide of 198 amino acids and is apparently the result of removal of some amino acids.
Big prolactin—approximately 48 kDa.[42] It may be the product of interaction of several prolactin molecules. It
appears to have little, if any, biological activity.[43]
Big big prolactin—approximately 150 kDa.[42] It appears to have a low biological activity.[44]
The levels of larger ones are somewhat higher during the early postpartum period.[45]

Prolactin receptor
Prolactin receptors are present in the mammillary glands, ovaries, pituitary glands, heart, lung, thymus, spleen, liver, pancreas, kidney,
adrenal gland, uterus, skeletal muscle, skin and areas of the central nervous system.[46] When prolactin binds to the receptor, it causes
it to dimerize with another prolactin receptor. This results in the activation of Janus kinase 2, a tyrosine kinase that initiates the JAK-
STAT pathway. Activation also results in the activation of mitogen-activated protein kinases and Src kinase.[46]

Human prolactin receptors are insensitive to mouse prolactin.[47]

Diagnostic use
Prolactin levels may be checked as part of a sex hormone workup, as elevated prolactin secretion can suppress the secretion of FSH
and GnRH, leading to hypogonadism and sometimes causing erectile dysfunction.

Prolactin levels may be of some use in distinguishing epileptic seizures from psychogenic non-epileptic seizures. The serum prolactin
level usually rises following an epileptic seizure.[48]

Units and unit conversions

The serum concentration of prolactin can be given in mass concentration (µg/L or ng/mL), molar concentration (nmol/L or pmol/L) or
in international units (typically mIU/L). The current IU is calibrated against the third International Standard for Prolactin, IS
84/500.[49][50] Reference ampoules of IS 84/500 contain 2.5 µg of lyophilized human prolactin[51] and have been assigned an activity
of .053 International Units.[49][50] Measurements that are calibrated against the current international standard can be converted into
mass units using this ratio of grams to IUs;[52] prolactin concentrations expressed in mIU/L can be converted to µg/L by dividing by
21.2. Previous standards use other ratios.[53][54][55][56]

The first International Reference Preparation (or IRP) of human Prolactin for Immunoassay was established in 1978 (75/504 1st IRP
for human Prolactin) at a time when purified human prolactin was in short supply.[52][53] Previous standards relied on prolactin from
animal sources.[56] Purified human prolactin was scarce, heterogeneous, unstable and difficult to characterize. A preparation labelled
81/541 was distributed by the WHO Expert Committee on Biological Standardization without official status and given the assigned
value of 50 mIU/ampoule based on an earlier collaborative study.[52][54] It was determined that this preparation behaved anomalously
in certain immunoassays and was not suitable as an IS.[52]

Three different human pituitary extracts containing prolactin were subsequently obtained as candidates for an IS. These were
distributed into ampoules coded 83/562, 83/573 and 84/500.[49][50][52][55] Collaborative studies involving 20 different laboratories
found little difference between these three preparations. 83/562 appeared to be the most stable. This preparation was largely free of
dimers and polymers of prolactin. On the basis of these investigations 83/562 was established as the Second IS for human
Prolactin.[55] Once stocks of these ampoules were depleted, 84/500 was established as the Third IS for human Prolactin.[49][52]

Reference ranges
General guidelines for diagnosing prolactin excess (hyperprolactinemia) define the upper threshold of normal prolactin at 25 µg/L for
women and 20 µg/L for men.[46] Similarly, guidelines for diagnosing prolactin deficiency (hypoprolactinemia) are defined as
prolactin levels below 3 µg/L in women[57][58] and 5 µg/L in men.[59][60][61] However, different assays and methods for measuring
prolactin are employed by different laboratories and as such the serum reference range for prolactin is often determined by the
laboratory performing the measurement.[46][62] Furthermore, prolactin levels also vary factors including age,[63] sex,[63] menstrual
cycle stage[63] and pregnancy.[63] The circumstances surrounding a given prolactin measurement (assay, patient condition, etc.) must
therefore be considered before the measurement can be accurately interpreted.[46]

The following chart illustrates the variations seen in normal prolactin measurements across different populations. Prolactin values
were obtained from specific control groups of varying sizes using the IMMULITE assay.[63]

Typical prolactin values

Proband Prolactin, µg/L
women, follicular
12.1
phase (n = 803)
women, luteal
13.9
phase (n = 699)
women, mid-
17
cycle (n = 53)
women, whole
13.0
cycle (n = 1555)
women,
pregnant, 1st 16
trimester (n = 39)
women,
pregnant, 2nd 49
trimester (n = 52)
women,
pregnant, 3rd 113
trimester (n = 54)
Men, 21–30 (n =
9.2
50)
Men, 31–40 (n =
7.1
50)
Men, 41–50 (n = 7.0
50)
Men, 51–60 (n =
6.2
50)
Men, 61–70 (n =
6.9
50)

Inter-method variability
The following table illustrates variability in reference ranges of serum prolactin between some commonly used assay methods (as of
2008), using a control group of healthy health care professionals (53 males, age 20–64 years, median 28 years; 97 females, age 19–59
years, median 29 years) in Essex, England:[62]
 Mean Lower limit Upper limit
Prolactin 2.5th percentile 97.5th percentile

Assay method µg/L mIU/L µg/L mIU/L µg/L mIU/L

Females
Centaur 7.92 168 3.35 71 16.4 348
Immulite 9.25 196 3.54 75 18.7 396
Access 9.06 192 3.63 77 19.3 408

AIA 9.52[64] 257[64] 3.89[64] 105[64] 20.3[64] 548[64]

Elecsys 10.5 222 4.15 88 23.2 492
Architect 10.6 225 4.62 98 21.1 447
Males
Access 6.89 146 2.74 58 13.1 277
Centaur 7.88 167 2.97 63 12.4 262
Immulite 7.45 158 3.30 70 13.3 281

AIA 7.81[64] 211[64] 3.30[64] 89[64] 13.5[64] 365[64]

Elecsys 8.49 180 3.40 72 15.6 331
Architect 8.87 188 4.01 85 14.6 310

An example usage of table above is, if using the Centaur assay to estimate prolactin values in µg/L for females, the mean is 7.92 µg/L
and the reference range is 3.35–16.4 µg/L.

Conditions

Elevated levels
Hyperprolactinaemia, or excess serum prolactin, is associated with hypoestrogenism, anovulatory infertility, oligomenorrhoea,
amenorrhoea, unexpected lactation and loss of libido in women and erectile dysfunction and loss of libido in men.[65]

Physiological Pharmacological Pathological

Coitus Anesthetics Hypothalamic-pituitary

stalk damage Pituitary
Exercise Anticonvulsant
Lactation Antihistamines Granulomas Acromegaly
Pregnancy (H2) Idiopathic
Infiltrations
Sleep Antihypertensives Lymphocytic
Radiation
Stress Cholinergic hypophysitis or
Rathke's cyst parasellar mass
agonist
Depression Trauma
Drug-induced Macroadenoma
hypersecretion Pituitary stalk (compressive)
Catecholamine resection Macroprolactinemia
depletor Suprasellar surgery Plurihumoral
Dopamine adenoma
Tumors
receptor blockers Prolactinoma
Dopamine Craniopharyngioma Systemic disorders
synthesis inhibitor Germinoma
Estrogens
 Oral Hypothalamic Chest-neurologic
contraceptives metastases chest wall trauma
Oral Meningioma Herpes Zoster
contraceptive Suprasellar Chronic renal
withdrawal pituitary mass failure
Neuroleptics extension Cirrhosis
Antipsychotics Surgery Cranial radiation
Neuropeptides Epileptic seizures
Opiates and opiate Polycystic ovarian
antagonists disease
Pseudocyesis
Chronic low levels
of thyroid hormone

Decreased levels
Hypoprolactinemia, or serum prolactin deficiency, is associated with ovarian dysfunction in women,[57][58] and arteriogenic erectile
dysfunction, premature ejaculation,[59] oligozoospermia, asthenospermia, hypofunction of seminal vesicles and hypoandrogenism[60]
in men. In one study, normal sperm characteristics were restored when prolactin levels were raised to normal values in
hypoprolactinemic men.[61]

Hypoprolactinemia can result from hypopituitarism, excessive dopaminergic action in the tuberoinfundibular pathway and ingestion
of D2 receptor agonists such as bromocriptine.

While there is evidence that women who smoke tend to breast feed for shorter periods, there is a wide variation of breast-feeding rates
in women who do smoke. This suggest that psychosocial factors rather than physiological mechanisms (e.g., nicotine suppressing
prolactin levels) are responsible for the lower rates of breast feeding in women who do smoke.[66][67]

In medicine
Prolactin is available commercially for use in animals, but not in humans.[68] It is used to stimulate lactation in animals.[68] The
biological half-life of prolactin in humans is around 15–20 minutes.[69] The D2 receptor is involved in the regulation of prolactin
secretion, and agonists of the receptor such as bromocriptine and cabergoline decrease prolactin levels while antagonists of the
receptor such as domperidone, metoclopramide, haloperidol, risperidone, and sulpiride increase prolactin levels.[70] D2 receptor
antagonists like domperidone, metoclopramide, and sulpiride are used as galactogogues to increase prolactin secretion in pituitary
gland and induce lactation in humans.[71]

See also
Breast-feeding
Epileptic seizure
Hyperprolactinaemia
Hypothalamic–pituitary–prolactin axis
Male lactation
Prolactin modulator
Prolactin receptor
Prolactin-releasing hormone
Prolactinoma
Weaning
References
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Summary?db=core;g=ENSMUSG00000021342) - Ensembl, May 2017
3. "Human PubMed Reference:" (https://www.ncbi.nlm.nih.gov/sites/entrez?db=gene&cmd=Link&LinkName=gene_pub
med&from_uid=5617). National Center for Biotechnology Information, U.S. National Library of Medicine.
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External links
MedlinePlus Encyclopedia Prolactin (https://medlineplus.gov/ency/article/003718.htm)

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