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