Pituitary production of prolactin and prolactin-suppressing drugs

Prolactin secretion from the anterior pituitary is mediated via dopaminergi c pathways. Any process that alters dopamine production or transport in the central nervous system may lead to hyperprolactinemia. Most cases of hyper prolactinemia are due to prolactin secreting pituitary tumors or to medicat ions which alter dopamine production. Prolactinomas cause amenorrhea, galac torrhea and infertility in women and impotence and neurological deficits in men. Dopamine receptor agonists are the mainstay of therapy for hyperprola ctinemia as they rapidly lower serum prolactin and cause tumor shrinkage. I n this paper we review the regulation of prolactin secretion, the clinical features and causes of hyperprolactinemia, and the use of dopamine agonists .