Last edited: 10/29/2021

7. PROLACTINE
Endocrinology | Prolactin Medical Editor: Dr. Ilia-Presiyan Georgiev

OUTLINE II) SYNTHESIS

I) ANATOMY Prolactin is synthesized in specific cells – lactotropes in

II) SYNTHESIS the anterior pituitary gland (adenohypophysis)
III) STIMULI AND INHIBITORS It is designed to promote lactation (milk production)
IV) EFFECT ON THE ALVEOLAR CELL
V) REVIEW QUESTIONS
VI) REFRENCES III) STIMULI AND INHIBITORS

I) ANATOMY (1) Prolactin inhibiting hormone (PIH) / Dopamine

Secreted by the arcuate nucleus
(1) Mammary glands
Goes through the hypophyseal portal system to the
Essentially modified apocrine glands (sweat glands) secondary capillary plexus in the anterior pituitary
Designed to produce milk. Inhibits the lactotropes
o Prevents prolactin secretion
(2) Structure
o Binds to D2 receptors
(i) Alveolar cells (2) Thyrotropin-releasing hormone (TRH)
o Produce milk Secreted by the paraventricular nucleus
o Affected by prolactin Goes through the hypophyseal portal system to the
 Stimulates the production of milk secondary capillary plexus in the anterior pituitary
(ii) Lobules Stimulates the lactotropes
o Stimulates the prolactin secretion
o Main part of the gland o Binds to specific receptors
o Tube-like structures
o Made up of alveolar cells (3) Breastfeeding
Direct stimulus on prolactin
(iii) Lobar connective tissue
The suckling of the baby activates mechanoreceptors.
o Between and around the lobules o They trigger the production of oxytocin and stimulate
the production of prolactin.
(iv) Suspensory (Cooper's) ligaments
Furthermore, suckling stimulates the paraventricular
o In the lobar connective tissue
nucleus to release more thyrotropin-releasing hormone
o Anchor the breast
o TRH stimulates the lactotropes to produce
 Mainly to the posterior wall
prolactin.
(v) Superficial fascia (4) High levels of Estrogen
o Around the lobules Extremely important for prolactin secretion
(vi) Lactiferous ducts. Produced from the ovaries
o during the pregnancy
o Little tubes o during the birthing process
o Drain the lobules o after the birthing process
(vii) Lactiferous sinuses Stimulate prolactin production directly
o In the lactotropes
o Dilation of the lactiferous ducts
o Just behind the nipple Stimulate prolactin production indirectly
o Inhibiting the arcuate nucleus secreting PIH
(viii) Nipple
(5) Extremely high levels of Estrogen
o On the surface end of the ducts
During pregnancy
(ix) Areola Stimulate the production of prolactin
o Around the nipple Inhibit prolactin’s effect on the alveolar cells
After the birthing process
o Estrogen levels start to fall down
o Prolactin starts to affect the alveolar cells

Figure 1 Structure of the mammary gland. Figure 2 Synthesis of prolactin.

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 IV) EFFECT ON THE ALVEOLAR CELL Suckling stimulates the production of Prolactin and:
a. Gonadotropin releasing hormone (GnRH)
Prolactin binds to specific receptors on the cell membrane b. Follicle stimulating hormone (FSH)
o Reaches them through the blood circulation c. Dopamine
It activates Janus kinase (JAK) d. Oxytocin
JAK activates signal transducer and activator of
transcription (STAT) In what way Estrogen affects the prolactin
STAT activates genes to transcribe mRNA production:
mRNA is translated into different proteins a. Stimulates directly
o Milk proteins b. Stimulates indirectly
 Casein c. Stimulates directly and indirectly
 Lactoferin d. Inhibits
o Kinases that phosphorylate different channels on the
cell membrane When the Estrogen levels are high enough to
 Ions and electrolytes stimulate Prolactin production but inhibit its effect?
 IgA and other plasma proteins a. During puberty
 Cholesterol and different lipids b. During pregnancy
 Vitamins c. During the birthing process
All those are directly excreted into the lumen of the d. After the birthing process
lactiferous ducts
Which protein is not part of the prolactin cascade?
a. Janus kinase
b. Signal transducer and activator of transcription
c. Adenylate Cyclase
d. mRNA

Which substance is not a milk ingredient?

a. Cholesterol
b. Casein
c. IgA
d. Prolactin

CHECK YOUR ANSWERS

VI) REFRENCES

● Le T, Bhushan V, Sochat M, Chavda Y, Zureick A. First Aid for

the USMLE Step 1 2018. New York, NY: McGraw-Hill Medical; 2017
Figure 3 Effect of prolactin on the alveolar cells. ● Marieb EN, Hoehn K. Anatomy & Physiology. Hoboken, NJ:
Pearson; 2020.
● Boron WF, Boulpaep EL. Medical Physiology.; 2017.
● Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL,
V) REVIEW QUESTIONS Loscalzo J. Harrison's Principles of Internal Medicine, Twentieth
Edition (Vol.1 & Vol.2). McGraw-Hill Education / Medical; 2018
What type of gland is the mammary gland? ● Hall JE, Hall ME. Guyton and Hall Textbook of Medical
a. Endocrine Physiology. Philadelphia, PA: Elsevier; 2021
b. Apocrine
c. Merocrine
d. Mucous

What is the main part of the mammary gland?

a. Alveolar cells
b. Gland lobules
c. Lactiferous ducts
d. Cooper’s ligaments

Where is prolactin synthesized?

a. Hypothalamus
b. Neurohypophysis
c. Adenohypophysis
d. Mammary gland

What is the effect of Dopamine?

a. Inhibits prolactin production
b. Stimulates prolactin production
c. Inhibits prolactin effect
d. Stimulates prolactin effect

What is the effect of thyrotropin-releasing hormone

(TRH)?
a. Inhibits prolactin production
b. Stimulates prolactin production
c. Inhibits prolactin effect
d. Stimulates prolactin effect

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