High Prolactin Levels Research Articles

Predictors of favorable long-term outcomes in first-line surgery for microprolactinomas.

Opting for first-line surgery in carefully selected patients with microprolactinomas provides the advantage of avoiding long-term dopamine agonist (DA) medication and potential associated side effects. However, the lack of comprehensive long-term data poses a challenge in identifying those patients who would benefit the most from upfront surgery. To improve guidance in the selection process for microprolactinoma patients in clinical practice, we aimed to establish simple clinical and biochemical parameters predicting non-dependence on DAs. Retrospective analysis of a prospectively maintained database, focusing on patients with microprolactinomas who underwent upfront surgery. We assessed clinical and biochemical risk factors for the patients' reliance on DAs at their latest follow-up using regression analysis. We next proceeded to conduct Receiver Operating Characteristic (ROC) analysis to determine the optimal threshold cutoff prolactin (PRL) level for practical application in clinical settings that best differentiates between surgical long-term remission status and long-term dependence on DAs. A microadenoma was observed in 46 patients, of whom 12 (26%) exhibited long-term dependence on DAs at a median follow-up of 78 months. Baseline PRL values were significantly higher in patients with long-term DA dependence compared to those without (p = 0.05). High baseline PRL values (HR 23.9, 95% CI 1.0-593.7, p = 0.05), but not the presence of headache or male gender, were identified as independent predictors of long-term dependence on DAs. PRL thresholds for discriminating long-term DA dependence were estimated to be 290µg/L (AUROC = 0.73, 95% CI 0.55-0.92, p = 0.03; sensitivity = 90%, specificity = 80%). In patients with microprolactinomas, first-line surgery presents a favorable prospect for reducing reliance on DAs. However, for those with high PRL levels ≥ 290µg/L at diagnosis, first-line surgery is not recommended, as the majority of them require adjuvant DA therapy in the long term.

Acupoint stimulation for postpartum breastfeeding insufficiency: a systematic review and meta-analysis

BackgroundInsufficient lactation, known as hypogalactia, is an important reason for weaning. To date, no effective methods have been established to increase lactation volume. With the advantages of low cost and convenience, acupoint stimulation—defined as any stimulation applied at acupoints—is a promising option.ObjectivesThe aim of this systematic review was to evaluate the effectiveness of acupoint stimulation for postpartum breastfeeding insufficiency.MethodsA systematic search of seven databases (PubMed, MEDLINE, Embase, Cochrane, CNKI, Airiti Library, ClinicalTrials.gov) was performed from their inception dates to September 30, 2023. Randomized trials were included. The inclusion criteria of the intervention included acupuncture, acupressure (including tuina and massage), electroacupuncture, laser stimulation, catgut embedding, and auriculotherapy. The primary outcomes were the amount of lactation and the level of prolactin. Secondary outcomes were colostrum time and adverse effects. The risks of bias were assessed using RoB 2.0.ResultsTwenty-four studies involving 3214 participants were included. When compared to the control group, the experimental group exhibited improved volume of milk production (MD = 81.30; 95% CI = 58.94–103.67) and higher prolactin levels (MD = 41.90, 95% CI = 28.57–55.22). Colostrum time was shorter in the control group ([MD = − 7.26; 95% CI = − 10.69 to − 3.83] for continuous data; [RR = 1.70; 95% CI = 1.38–2.08] for dichotomous data). Adverse effects were reported in only one trial, which included three cases of fear of acupuncture and one case of hypotension.ConclusionsAcupoint stimulation may have beneficial effects on postpartum breastfeeding insufficiency. However, the results should be interpreted with caution because of the presence of risks of bias and heterogeneity among studies.

Prolactin in sleep and EEG regulation: New mechanisms and sleep-related brain targets complement classical data.

The role of prolactin in sleep regulation has been the subject of extensive research over the past 50 years, resulting in the identification of multiple, disparate functions for the hormone. Prolactin demonstrated a characteristic circadian release pattern with elevation during dark and diminution during light. High prolactin levels were linked to non-rapid eye movement sleep and electroencephalogram delta activity in humans. Conversely, hyperprolactinemia showed strong correlation with REM sleep in rodent studies. Prolactin may be implicated in the alterations in female sleep patterns observed during the reproductive cycle, it may play a role in the REM sleep enhancement following stress and in sleep-related immunological processes. In conclusion, prolactin appears to have a sleep-promoting role, particularly during the dark phase. However, it does not appear to play a central and coherent role in sleep regulation, as observed in some neuropeptides such as orexin. Conversely, its principal function may be to facilitate situational, yet adaptive, changes in sleep patterns in response to challenging physiological phases, such as those associated with stress, immunological challenges, or the reproductive cycle. Neuronal substrates for prolactin-mediated sleep effects remain unknown; however, recent rodent sleep studies may provide insights into the potential sites of these effects.

Pseudopregnancy in dromedary camels: Characterization, prevalence, and clinical and hormonal properties.

Pseudopregnancy is the development of signs of pregnancy in the absence of an embryo or fetus. The objectives of this study were to characterize pseudopregnancy in dromedary camels, determine its prevalence in camel farms and practice, identify associated risk factors, and describe its clinical and hormonal properties. The prevalence of pseudopregnancy on 100 camel farms with 4264 total female camels was determined to be 2.07% (86/4264) overall, while the rate among infertile animals was 17.68% (1385/7833). The genital tracts of 58 pseudopregnant female camels were examined, and their breeding histories were examined. Serum concentrations of estradiol-17 β (E2), progesterone (P4), and prolactin (PRL) in these animals were assessed. Five cyclic camels and five in early pregnancy were used as control subjects. Signs of pseudopregnancy included being anestrous, refusing to mate, and adopting a stiffened posture-with the head held high and the tail cocked-when approached by a male. Normal pregnancy-associated mammary and abdominal changes were absent. Risk factors associated with pseudopregnancy included age (odds ratio [OR]=21.63, P=0.0001) and a history of reproductive disorders (OR=4.155, P=0.042). Based on their P4 levels, the pseudopregnant camels were classified as either typical (high P4, 16/58, 27.59%) or atypical (low P4, 42/58, 72.41%). The main clinical findings in the camels with typical pseudopregnancies were a narrow/closed cervix (56.25%), clinical endometritis (CE; 43.75%), and pyometra (31.25%), while those with atypical pseudopregnancies exhibited CE (50%) and luteinized follicles (43.1%). The pregnant camels had significantly (P=0.0001) higher serum P4 concentrations (2.44±0.32ng/mL) than the pseudopregnant (0.68±0.12ng/mL) and cyclic camels (0.16±0.01ng/mL). Serum E2 levels did not differ significantly among the pseudopregnant (43.2±1.05pg/mL), pregnant (47.72±4.06pg/mL), and cyclic (40.72±1.03pg/mL) camels. The pregnant camels had a significantly (P=0.04) higher average serum PRL concentration (3.61±0.45ng/mL) than the pseudopregnant (2.77±0.12ng/mL) and cyclic camels (2.18±0.11). In conclusion, pseudopregnancy in camels exhibits the same external signs that characterize pregnancy, but pseudopregnancy involves an absence of edema of the udder, milk production, and high PRL levels. We propose a division of pseudopregnant camels into typical and atypical classes, depending on whether they have high P4 levels. Pseudopregnancy is associated with a high incidence of other reproductive disorders, particularly in older camels.

Effect of circulating prolactin, lactation days, and seasonal variations on first artificial insemination pregnancy rates using the PG7G protocol in dairy cows

Background and Aim: Dairy farm profitability is linked to milk yield and reproductive efficiency. High prolactin levels during lactation can negatively impact fertility. Timed AI protocols like PG7G are used to improve pregnancy rates. This study investigates the effects of extending the voluntary waiting period (VWP) from 63 to 73 days after the PG7G protocol on reproductive parameters, including progesterone and prolactin levels, pregnancy rates, and pregnancy losses, in lactating Holstein cows during summer and winter seasons. Materials and Methods: A total of 2100 lactating dairy cows were divided into groups and assigned to the PG7G protocol based on their parity. Two groups were formed based on the number of days in milk (DIM) after the first PGF2α injection. The first group (PG7G-63) received a PGF2α injection 30-day postpartum (pp) and followed a specific protocol. The second group, PG7G-73, followed the same protocol but received a PGF2α injection 40-day pp. Pregnancy was confirmed, and blood samples were collected for analysis. Temperature and humidity were also recorded throughout the study. Results: Extension of the VWP to 73-day (PG7G-73 group) significantly improved pregnancy rates on day 47 pp compared with the 63-day VWP (PG7G-63 group). However, the PG7G-63 group exhibited lower PLs. Seasonality markedly influenced reproductive outcomes, with higher P/AI in the moderate season for primiparous cows and in the hot season for multiparous cows. Conversely, PL in both groups increased during the hot season. Conclusion: Extending the VWP from 63 to 73 days pp in lactating Holstein cows significantly improved pregnancy rates, while seasonality affected reproductive outcomes, with higher pregnancy rates in moderate temperatures and increased pregnancy loss during hot seasons. Keywords: dairy cows, days in milk, pregnancy rate, prolactin, season, timed artificial insemination.

Abnormalities in Blood Parameters in Athletes Taking Anabolic Androgenic Steroidal Agents; an Observational Clinical Study.

Many studies indicate that high and multiple doses of anabolic-androgenic steroids (AAS) for athletic enhancement can result in serious and irreversible adverse effects. A study that includes laboratory blood testing to evaluate the direct effects of AAS agents among users has not been previously undertaken. The purpose of this study was to investigate the adverse effects of the use of AAS by athletes and to determine whether AAS use leads to changes in certain blood parameters. This is an observational study consisting of two stages. First, the participants completed an online questionnaire assessing sociodemographic characteristics, and knowledge and attitudes towards AAS. Second, volunteers underwent laboratory blood testing. Analysis was conducted using frequency distributions and percentages of responses across various variables. Thirty-one individuals completed the online questionnaire, 18 of whom continued to stage 2, where blood samples were taken to trace any changes in blood parameters. All the participants were male, with an age range of 24-45 years. The results showed that 94% of the participants used AAS for nontherapeutic purposes. Most participants reported that they take a combination of AAS (96%), as well as in combination with other supplements (74%). The most used combination was testosterone plus growth hormone (45%), and the most used supplements were liver protectors (84%). Seventy-four percent of the participants reported side effects, and 28% had received a medical diagnosis, such as hypertension, hyperlipidemia or an infertility. High levels of testosterone, prolactin, alanine transaminase (ALT), aspartate transferase (AST) and lipid profile, and low luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were observed. The unsupervised use of AAS alone or in combination with other hormones and/or supplements may lead to adverse effects. Further studies with larger samples are needed to draw significant conclusions about the safety of using AAS.

Clinical review and drug sensitivity test of Corynebacterium kroppenstedtii complex isolates in non-lactating patients with severe mastitis

BackgroundPrevious microbiological investigations have demonstrated a significant correlation between Corynebacterium kroppenstedtii complex (CKC) infection and mastitis. Recent studies have confirmed the existence of the CKC, with Corynebacterium parakroppenstedtii (C. parakroppenstedtii) identified as the primary infectious agent. Examining the incidence of CKC in cases of severe non-lactational mastitis, alongside the clinical characteristics of infected patients, as well as evaluating the drug sensitivity testing protocols for CKC, can provide a more robust foundation for the diagnosis and treatment of CKC infections.MethodsData regarding the diagnosis and treatment of non-nursing patients with severe mastitis who underwent surgical intervention were extracted from the hospital’s electronic medical record system. Additionally, drug susceptibility tests were conducted on 15 strains of CKC isolated from mammary abscesses as well as DSM 44385 model strains. The effects of β-NAD and Tween80 (TW80) on the antibiotic susceptibility test by AGAR dilution and micro broth dilution were analyzed.ResultsIn this study, C. parakroppenstedtii accounted for 80% (12/15) of the isolates, while Corynebacterium pseudokroppenstedtii made up 13.3% (2/15), and Corynebacterium kroppenstedtii was identified in only 6.7% (1/15) of the cases. There were significant differences in age at first delivery (p < 0.001), prolactin (p < 0.001), CRP (p < 0.05), WBC (p < 0.05), and NEUT (p < 0.05) between CKC positive group and CKC negative group. In the AGAR dilution test, the addition of β-NAD only caused acceptable differences in penicillin G and ciprofloxacin but did not affect 12 antibiotics. There are 14 drugs with good coincidence rates (92.9%) in the micro broth dilution method and agar dilution method without the addition of β-NAD. The addition of 0.05% (v/v) TW80 resulted in all strains being resistant to penicillin G. Daptomycin is not suitable for the micro broth dilution method.ConclusionElderly primiparas with high prolactin levels have a higher risk of CKC infection. The micro broth dilution method is not applicable for EUCAST drug susceptibility testing for CKC and there is no suitable drug susceptibility evaluation procedure for daptomycin against CKC.

Clinical Correlates of Antipsychotic Plasma Levels with Long-Acting Paliperidone: Corrélats cliniques des concentrations plasmiques de palipéridone à libération prolongée.

The majority of patients with schizophrenia experience dramatic improvement in psychotic symptoms when treated with antipsychotic medication. Maintenance treatment can prevent relapses but problems with medication adherence limit effectiveness. Long-acting injectable antipsychotics (LAIs) provide an opportunity to establish adherence but challenges remain in ensuring that the dose selected is therapeutic. Therapeutic drug monitoring has not been established as valuable for LAIs in the maintenance treatment of schizophrenia. This exploratory study was undertaken to describe plasma paliperidone levels in outpatients treated with the LAI paliperidone palmitate and to determine whether paliperidone levels are associated with subjective experience on medication and side effects. Twenty-one outpatients with schizophrenia receiving treatment with LAI paliperidone consented to participation in this study. Blood samples were obtained for measurement of paliperidone and prolactin levels at the first visit. A second paliperidone level was obtained at the time of the next injection for 18 of the participants. Clinical rating scales were administered at the first visit to assess illness severity, attitudes regarding medication, subjective well-being and side effects. Paliperidone levels were highly correlated at the two time points (ρ = .85; P < .001). Mean paliperidone level at the first visit was 34.9 ng/ml and ranged from 5.1 to 73.9 ng/ml. Higher paliperidone levels were correlated with higher prolactin levels (ρ = 0.59, P < .01) and lower sexual desire (ρ = -.58, P < .01). We demonstrated that paliperidone levels can be measured reliably in patients receiving LAI paliperidone. Higher plasma levels were associated with higher prolactin levels and reduced sexual desire but not with measures of subjective experience on medications or other side effects. Measurement of paliperidone levels in patients treated with paliperidone palmitate may have the potential to minimize the dose of medication prescribed and, in turn, the severity of sexual side effects.

7497 Association between Plasma Prolactin Levels and Menopausal Vasomotor Symptoms

Abstract Disclosure: F. Galbiati: None. J. Kang: None. D.J. Cote: None. J.E. Manson: None. U.B. Kaiser: None. Background: High prolactin (PRL) levels inhibit gonadotropin-releasing hormone (GnRH), causing hypogonadism. GnRH release is regulated by neurokinin B (NKB) and kisspeptin. NKB antagonists are used in treatment of menopausal hot flashes and vasomotor symptoms (VMS). In mice and humans with hyperprolactinemic anovulation, kisspeptin restored ovarian cyclicity and LH pulsatility. However, the interplay between kisspeptin and PRL is not fully understood. In two menopausal women with hyperprolactinemia and central hypogonadism, treatment with bromocriptine led to PRL normalization and new-onset VMS, suggesting that hyperprolactinemia inhibited VMS associated with hypogonadism. We aimed to investigate the association between PRL and menopausal VMS in women from the Nurses’ Health Study I and II (NHS, NHSII). We hypothesized that women with higher PRL levels would have a lower frequency/severity of menopausal VMS. Methods: We conducted a cohort study of 2618 females enrolled in NHS (n=1692) and NHSII (n=926) in whom blood samples were collected between 1989-99, were not pregnant or on hormonal therapy, and were either pre or post-menopausal as of blood draw. Subjects were free of breast, ovarian and other cancers, and provided complete data on VMS at menopause as well as in the past 4 weeks (assessed in 2008 in NHS and 2009, 2013, 2017 in NHSII). Plasma PRL was measured as part of 28 case-control studies of various health outcomes. We evaluated the presence and severity of VMS at menopause and 4 weeks prior to the questionnaire, as well as duration (in years) of VMS. We used multiple logistic regression, adjusting for covariates to estimate multivariable-adjusted relative risks (MVRRs) and 95% confidence intervals (CIs). Results: Women were aged 33-65 years at blood draw; range for years from blood draw to menopause was -10 to 10 (median=1.8) years; range for years from blood draw to report of VMS (both at menopause and current VMS) was 9.8 to 22 years. Mean PRL (SD; range) was 14.7ng/mL (10.1; 0.08-246). Women with the highest PRL levels were likely to be younger and less likely to be current smokers or obese. 77.4% of women reported VMS at menopause and 47.6% in recent 4 weeks; 52.3% reported moderate-to-severe VMS at menopause and 32.0% reported VMS in recent 4 weeks. Overall, PRL was not associated with duration of VMS or moderate-to-severe VMS at menopause or in the past 4 weeks; compared to the lowest quintile (≤8.0ng/mL), those in the highest PRL quintile (≥18.2ng/mL) had MVRR of 1.23(95%CI=0.94,1.60) for moderate-to-severe menopausal VMS and 1.03(95%CI=0.67,1.59) for recent VMS. Menopausal status did not affect the association between prolactin levels and VMS. Conclusion: PRL levels were not associated with occurrence, severity, or duration of menopausal VMS in a large cohort of women. Presentation: 6/1/2024

7778 Factors Predicting Recovery of Hypogonadism in Men with Prolactinoma Treated with Dopamine Agonists

Abstract Disclosure: S. Constantinescu: None. O. Alexopoulou: None. D.M. Maiter: None. Introduction: Recovery of hypogonadism is an important objective of dopamine agonist (DA) treatment in men with prolactinoma. However, the extent, timeline, and predictive factors of gonadotrope axis recovery are still unclear. Methods: We report data from a large cohort of 89 men with prolactinoma, looking at the evolution of testosterone levels after 6 and 12 months of treatment with DA. We excluded patients with peripheral hypogonadism, surgical treatment performed less than 12 months after onset of DA treatment, and patients with small tumors (≤ 5 mm and prolactin ≤ 50 µg/l) who did not achieve tumor shrinkage during treatment. We defined low testosterone as a morning value &amp;lt; 10 nmol/l. Patients who had started testosterone supplementation were considered as having persistent hypogonadism. Results: Among the 89 men (mean age ± SD: 44 ± 14 years; 65/89 with a macroprolactinoma), 14 (16%) had normal initial testosterone levels (NT) and 75 (84%) had low testosterone at diagnosis (LT). Compared to LT, NT patients had significantly lower PRL (median 53 µg/l versus 490 µg/l, p=0.009) and smaller tumors (median 6.5 mm versus 21.2 mm, p=0.013). In the NT group, after 6 (n=11) and 12 months (n=10), testosterone rose from a median of 13.4 to 16.6 (p=0.266) and 17.9 nmol/l (p=0.012), respectively. In LT patients, after 6 (n=56) and 12 months (n=42), testosterone rose significantly from a median of 5.8 to 10.7 (p&amp;lt;0.001) and 12.5 nmol/l (p&amp;lt;0.001).In the LT group, 45% (32/71) had recovered eugonadism at 6 months and 57% (40/70) at 12 months. These proportions rose to 61% (22/36) and 67% (n=26/39) at 6 and 12 months when prolactin concentrations were normalized. Factors associated with persistent hypogonadism after one year were chiasmal compression at diagnosis (p=0.05), cavernous sinus invasion (p=0.042), cystic tumoral component (p=0.038), a greater tumoral diameter (mean 25 mm vs 15 mm, p&amp;lt;0.01), lower testosterone concentrations at diagnosis (mean 3.6 nmol/l vs 6.8 nmol/l, p&amp;lt;0.001) and at 6 months (mean 6.0 nmol/l vs 13.0 nmol/l, p&amp;lt;0.03), and higher prolactin levels at one year (median 17.15 µg/l vs 8.4 µg/l, p=0.064). Testosterone &amp;lt; 6.7 nmol/l at 6 months predicted the long-term persistence of hypogonadism with 72% sensitivity and 92% specificity. Conclusion: The sensitivity of the gonadotrope axis to high prolactin levels is highly variable in men with prolactinoma and 16% of them retain normal testosterone concentrations. However, this finding does not exclude partial inhibition of the gonadotrope axis that will improve with DA treatment. In patients with low testosterone levels, the recovery rate of hypogonadism is 45% at 6 months and 57% at 12 months, increasing to 67% if prolactin is normalized. Testosterone supplementation could be started early in patients with large, invasive, cystic and/or compressive tumors, with a testosterone concentration lower than 6.7 nmol/L after 6 months of treatment. Presentation: 6/3/2024

Precocious Puberty with Short Stature in a Girl: A Rare Case of Van Wyk–Grumbach Syndrome

Abstract Background: Precocious puberty (PP) is common in children and manifests commonly with increased linear growth. Van Wyk–Grumbach (VWG) syndrome is a rare cause of PP with short stature and delayed bone age. Clinical Description: An 11-year-old girl presented with early menarche, menorrhagia, and stunted height. Examination revealed pallor, dry skin, absence of axillary and pubic hair, and the presence of breast development (Tanner stage 3). A magnetic resonance imaging of the brain by a primary physician revealed a pituitary mass and was referred to neurosurgery, who, however, referred the child to us endocrinologists. Management and Outcome: Standard protocol-wise approach showed short stature with delayed bone age, high levels of thyroid-stimulating hormone, follicle-stimulating hormone and prolactin, raised antithyroid peroxidase antibodies along with multicystic ovaries bilaterally, thus cliniching the diagnosis of VWG Syndrome. The patient was started on levothyroxine and showed remission of symptoms and normalization of thyroid function tests as well as pituitary size. Conclusion: It is important to be aware that VWG syndrome may be a cause of PP in which the increase in size of the pituitary is reversible with initiation of thyroxine therapy along with complete resolution of all symptoms, avoiding unnecessary surgical interventions.

Clinical and diagnostic evidence of benign endometrial pathology in postmenopausal patients

The objective: to study clinical and diagnostic features of the benign endometrial conditions in the postmenopausal women.Materials and method. 64 postmenopausal patients with various severity of postmenopausal vaginal bleeding were examined. All patients underwent clinical, radiological, laboratory and histological examinations, reproductive history data and body mass index indicators were evaluated. Of them 33 persons were diagnosed with complex endometrial hyperplasia without atypia, 16 women – endometrial polyp and 15 women – hyperplasia with atypia. Routine gynecological examination including abdominal and pelvic examination following transvaginal ultrasound examination for the determination of the uterine and ovarian volume as well, as the endometrial thickness were conducted. Patients included in the study underwent computer tomography and magnetic resonance imaging as indicated. All patients with endometrial pathology underwent endometrial biopsy by standard dilatation and curettage or Pipelle-biopsy with histological examination of the obtained material. The concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEA-S), estradiol, estrone, progesterone, prolactin, and testosterone were determined in blood serum.Results. It was confirmed that in 87,5% of cases endometrial hyperplasia manifested with vaginal bleeding. Endometrial thickness in examined persons ranged from 14.1±1.6 mm in patients with atypical endometrial hyperplasia to 21.3±4.8 mm in patients with complex endometrial hyperplasia without atypia. The study of blood levels of hormones found that postmenopausal patients with endometrial hyperplasia have lower FSH concentration, LH/FSH ratio, estradiol, testosterone levels, with significantly high values of prolactin, DHEA-S and estrone. During the postmenopausal period, hyperplasia was developed in 10% of cases by the presence of bleeding, and 86.2% of cases by the presence of blood spotting. Conclusions. The study suggests that high body mass index, numerous artificial abortions, high blood levels of estrone, DHEA-S and prolactin as well as increased thickness of endometrium influence the frequency of endometrial hyperplasia in postmenopausal women.

The role of prolactin levels in metabolic syndrome: a systematic review

Introduction and purpose: Prolactin is primarily associated with lactation and gonadal function, but it also has metabolic effects. Recent research shows prolactin's role in food intake, body weight, glucose, and lipid profile. Both low and excessive prolactin levels can lead to metabolic dysfunctions such as metabolic syndrome, type 2 DM, and dyslipidemia. Dopamine agonists, like cabergoline, used to treat hyperprolactinemia, may help balance metabolic homeostasis, likely due to their effect on prolactin. This study aims to synthesize current research on prolactin's metabolic effects, focusing on metabolic syndrome.State of knowledge: Metabolic syndrome is a cluster of dysfunctions like central obesity, atherogenic dyslipidemia, hypertension, and insulin resistance. It increases the risk of diabetes and cardiovascular diseases, affecting a quarter of the European population. Different combinations of metabolic syndrome components require various treatment approaches. New research focuses on prolactin and dopamine agonists in its pathogenesis and treatment.Materials and methods: This literature review is based on PubMed materials using keywords “prolactin,” “hyperprolactinemia,” “hypoprolactinemia,” “metabolic syndrome,” “diabetes mellitus,” “obesity.”Conclusions: This study highlights prolactin's importance in metabolic homeostasis, finding a positive correlation between both low and high prolactin levels and metabolic syndrome. However, gender differences and the pathogenesis of metabolic disorders should be further explored.

Effect of prolactin concentration during the dry period on the subsequent milk production of dairy cows

Shortening the dry period has a negative impact on milk production of the following lactation. One possible explanation is that a period of low prolactin (PRL) concentration is necessary to restore mammary gland milk production capacity. Therefore, the objective of this study was to determine the effect of lowering blood PRL level on subsequent lactation milk production. In this experiment, quinagolide was used to inhibit PRL secretion during the dry period. Thirty Holstein cows were randomly assigned one of 3 dry period managements: a conventional (60 d) dry period (CD) and 2 short (35 d) dry period treatments (SD). Short dry period cows received either water (SDwater) or quinagolide (2 mg, SDquin) injections twice daily from dry-off until 14 d before calving. Cows were followed during the first 20 wks of the subsequent lactation. When CD cows were dry but SD cows were lactating, concentration of PRL was lower in the CD cows than in the SD cows. During the injection period, PRL of SDquin cows was lower than that of the other treatments and was greater in the blood of SDwater than in that of CD cows. After the injection period until calving, no difference in PRL concentration was observed between treatments. After calving, PRL concentration of the SDquin cows was greater than those of CD and SDwater cows. During the first 20 wks of lactation, energy corrected milk (ECM) was lower in SDwater cows than in CD and SDquin cows. The ECM of the latter groups were not different. During the same period, mammary expression of genes related to milk synthesis, pro-apoptotic genes, as well as the expression of the short and long isoforms of the PRLR genes were not affected; however, the expression of SOCS3 gene tended to be lower for the SDquin than the SDwater cows. Lowering the PRL level during short dry period restored milk production to the level normally observed after a conventional dry period, which suggests that higher PRL levels during short dry period are the cause of the lower milk production after a short dry period. Ultimately, strategies to lower blood PRL level may help the adoption of short dry period.

Effects of Clinical Mastitis on Reproductive Performances in Dairy Cows

The study was undertaken to study the productive and reproductive performances in clinical mastitis (CM) affected and apparently, healthy dairy crossbred cows and to analyze the effects of mastitis considering age, lactation, and severity of mastitis on reproductive performances in crossbred cows. A survey using a questionnaire was done to record different parameters of the cows during the period November 2021 to March 2022. A total of 58 lactating cows included in this study were divided into two groups named mastitis (n=24) and controlled (n=34). Cows of the mastitis groups were divided into subgroups depending on the age, lactation number and severity of mastitis. Prolactin (PRL), progesterone (P4) and estrogen (E2) levels of cows at the time of AI were analyzed. The results showed that cows of the mastitis group had substantially (P&lt;0.01) higher values for Days to first heat detection after parturition (96.16±6.20), Days to first insemination after parturition (105.00±6.64), Days open (140.58±7.40), and number of services per conception (2.33±0.11). The results also indicated that the greatest values were seen in the cows of Sub-group age &gt;8 for Milking Yield (16.21±2.39 Lt), Days to first heat detection after parturition (109.29±13.57), Days to first insemination following parturition (122.14±15.87), and Days open (165.79±16.70), and in cows of Sub-group 7-8 had for the Days of incidence of mastitis following parturition (51.57±12.73). Considering the number of lactations, we observed the highest values of Milking Yield (16.69±2.20 Lt), Days to first heat detection after parturition (108.75±11.58), Days to first insemination following parturition (120.00±13.96), and Days open (160.63±15.20) in cows of Sub-group lactation number &gt;3 and the highest Days of occurrence of mastitis after parturition in cows of Sub-group lactation number 3. Based on the degree of clinical mastitis, it was found that cows of the severe mastitis sub-group had the greatest Milking Yield (24.80±5.40 Liter) at a significant level (P&lt;0.05). This result indicates an association of severe CM with a high yield of milk. Whereas, there was no significant (P&gt;0.05) variation observed in different parameters in terms of reproductive performances in all sub-groups. In addition, significantly (P&lt;0.01) higher prolactin levels (16.10 ±1.17 ng/ml) and low estrogen levels (13.86±0.57 pg/ml) were present in CM-affected cows. This study could help veterinarians in taking strategies to minimize and control the negative effect of clinical mastitis on the reproduction of dairy cows. J. of Sci. and Tech. Res. 5(1): 01-07, 2023

Gender Differences in Patients with Prolactinoma: Single-center Ukrainian Experience.

Prolactinomas are the most common type of pituitary gland tumors that secrete overly prolactin. They account for approximately 60% of all hormone-secreting hypophysis tumors. This study aims to analyze gender differences in patients with prolactinomas who were operated on transsphenoidal surgery and conduct a single-center retrospective analysis of patient data. This study evaluated the medical records of 109 patients (61 females and 48 males) from 2009 to 2019 at Feofaniya Clinical Hospital of the State Administration of Affairs in Kyiv, Ukraine. The primary criterion for including patients was a Serum Prolactin (PRL) level of over 100 ng/ml and the presence of a pituitary adenoma (PA) as observed on MRI. Additionally, the histological examination needed to confirm the presence of Prolactin-Secreting Pituitary Adenomas (PSPAs) without plurihormonal activity through both microscopy and immunohistochemical (IHC) staining. Significant differences in preoperative PRL levels were not observed. However, males had significantly larger tumor sizes and prevalence of macroadenomas. In male patients, the preoperative PLR levels showed a weak negative correlation with age (r=-0.304, p < 0.036) and a positive correlation with tumor size (r=0.555, p < 0.001) and cavernous sinus invasion (r=0.339, p < 0.018). In females, preoperative PRL was significantly associated only with tumor size and Knosp grade. Prolactin-Secreting Pituitary Adenomas (PSPAs) are more common in women than men and are characterized by larger and more invasive tumors with high PRL levels at diagnosis. The PRL level and tumor size before surgery can predict early biochemical remission in both males and females with an accuracy of 58.3% and 68.8%, respectively.

The association of prolactin and gonadal hormones with cognition and symptoms in men with schizophrenia spectrum disorder: Divergent effects of testosterone and estrogen

BackgroundCertain antipsychotics elevate prolactin levels in patients with schizophrenia spectrum disorders (SSD), potentially affecting cognition, symptoms, and hormone levels. This study examines the association between prolactin, testosterone, and estrogen and cognition and symptoms in men with SSD, considering antipsychotic medication. MethodsThis cross-sectional study included 128 men with SSD and 44 healthy men from two trials. Patients were divided into a prolactin-sparing (n = 53) and prolactin-raising group (n = 75) based on antipsychotic medication. We examined the association between hormones (testosterone, estrogen and prolactin), and cognition and symptoms using backward linear regression. Three domains of cognition were assessed including: processing speed, verbal fluency, and working memory, while symptoms were measured using the Positive and Negative Syndrome Scale (PANSS). ResultsProlactin levels were highest in the prolactin-raising group, followed by the control group, and lowest in the prolactin-sparing group (H = 45.279, p < .001). Testosterone and estrogen levels did not differ significantly between groups. In the prolactin-raising group, prolactin negatively correlated with testosterone (r(73) = −0.32, p = .005). Higher testosterone predicted better cognitive functioning (working memory: β = 0.20, p = .007, verbal fluency: β = 0.30, p = .001) and lower symptom scores (total: β = −0.21, p = .001; negative: β = −0.24, p = .002) in men with SSD. Conversely, higher estrogen levels related to slower processing speed (β = −0.22, p < .001) and higher symptoms scores (β = 0.23, p = .010) in men with SSD. ConclusionThe results suggest positive associations between testosterone and cognition and symptoms in men with SSD, while suggesting that high prolactin levels could relate to lower testosterone levels, possibly worsening cognition and symptoms in men with SSD.

(124) GENITOURINARY SYNDROME OF LACTATION (GSL): A NEW PERSPECTIVE ON POSTPARTUM AND LACTATION-RELATED GENITOURINARY SYMPTOMS

Abstract Introduction Genitourinary syndrome of menopause (GSM) is a well-documented and researched condition characterized by a range of genitourinary symptoms in peri- and postmenopausal women. Similar to GSM, postpartum and lactating women experience significantly reduced estrogen and androgen levels. However, there is limited research on the occurrence and impact of similar symptoms during the postpartum and breastfeeding period, as well as possible treatment options. Objective The aim of this project was to review the available literature for genitourinary health in the postpartum breastfeeding population and summarize the key findings and potential treatment options. Methods We performed a comprehensive literature review utilizing several databases and the following keywords individually or in combination “physiology of postpartum” or “physiology of lactogenesis” or “vulvovaginal health” or “vaginal atrophy” or “vaginal dryness” or “dyspareunia” or “urinary incontinence” or “lactation” or “breastfeeding” or “vaginal estrogen.” Full text review of 75 articles was performed, and ultimately 50 articles were included in this review. Results During lactation, high levels of prolactin inhibit estrogen and androgen secretion via negative feedback mechanisms (1). These hormonal changes lead to an increased prevalence (of up to 50% higher) of vulvovaginal atrophy in lactating and breastfeeding women compared to non-breastfeeding women (2,3). The shift in hormones also contributes to increased rates (~30% higher) of dyspareunia (4–7), likely due to a lack of vaginal lubrication (up to 46%) among breastfeeding women (8). Decreased sexual desire is also common and reported to be experienced by up to 46% of postpartum women (8). Despite these highly prevalent and potentially devastating symptoms, there is a lack of consistent screening at postpartum visits and no treatment guidelines available to healthcare providers. Similar to GSM, vaginal lubricants can be used by breastfeeding women with vaginal dryness. However, for lactating women with refractory vaginal dryness or significant vulvovaginal changes, vaginal estrogen or DHEA therapy may be considered. Studies have shown minimal or no transfer of estrogen to breast milk even at high concentrations, and no reduction in breast milk supply (9–11), likely because vaginal estrogen is not a systemic dose. Studies on vaginal estrogen therapy in postpartum women are limited, but one randomized placebo-controlled trial showed excellent compliance and a subjective improvement in women utilizing vaginal estrogen (12). Conclusions Postpartum breastfeeding women experience similar physiology and symptoms to the postmenopausal phase, as seen in GSM. We propose the introduction of a novel term to describe the genitourinary changes seen in breastfeeding individuals: Genitourinary Syndrome of Lactation (GSL). The creation and diagnostic use of a syndrome, such as GSL, will equip healthcare providers with an all-encompassing term to bring awareness to the symptoms experienced by postpartum breastfeeding individuals. This awareness can lead to improved screening and treatment guidelines for the high numbers of breastfeeding individuals suffering from these genitourinary changes. Disclosure No.

Genitourinary syndrome of lactation: a new perspective on postpartum and lactation-related genitourinary symptoms.

The genitourinary syndrome of menopause (GSM) is a well-documented condition characterized by a range of genitourinary symptoms in peri- and postmenopausal women. As with GSM, postpartum lactating women experience reduced estrogen and androgen levels. However, there is limited research on the impact of symptoms during the postpartum breastfeeding period. The aim was to review the literature for genitourinary health in the postpartum breastfeeding population and summarize key findings and potential treatments. We performed a comprehensive literature review in PubMed, Google Scholar, and Scopus from inception of database to November 2023 using the following keywords individually and in combination: "physiology of postpartum" or "physiology of lactogenesis" or "vulvovaginal health" or "vaginal atrophy" or "vaginal dryness" or "dyspareunia" or "urinary incontinence" or "lactation" or "breastfeeding" or "vaginal estrogen." All identified articles published in English were considered. Relevant studies were extracted, evaluated, and analyzed. The work presented in this article represents a summative review of the identified literature. During lactation, high levels of prolactin inhibit estrogen and androgen secretion via negative feedback, which leads to an increased prevalence of vulvovaginal atrophy, vaginal dryness, dyspareunia, and urinary incontinence in lactating postpartum women. Despite these highly prevalent and potentially devastating symptoms, there is a lack of consistent screening at postpartum visits and no treatment guidelines available to health care providers. Postpartum breastfeeding women experience similar physiology and symptoms to the postmenopausal phase, as seen in GSM. We propose the introduction of a novel term to describe the genitourinary changes seen in postpartum breastfeeding individuals: genitourinary syndrome of lactation. The diagnostic use of genitourinary syndrome of lactation will equip health care providers with an all-encompassing term to bring awareness to the symptoms experienced by postpartum breastfeeding individuals and lead to improved screening and treatment for the high numbers of individuals experiencing these genitourinary changes.

High levels of serum prolactin associated with antipsychotic use: Should we be concerned? About two cases

High levels of serum prolactin associated with antipsychotic use: Should we be concerned? About two cases