Galactorrhoea and Prolactinomas Overview

What is galactorrhoea primarily associated with?

Which hormone primarily stimulates breast milk production?

What role does dopamine play in relation to prolactin secretion?

Which of the following can be used to suppress prolactin secretion?

Hyperprolactinaemia can lead to reduced release of which hormones?

What visual field defect is associated with a pituitary tumor pressing on the optic chiasm?

Which statement is true regarding the relationship between oestrogen, progesterone, and prolactin during pregnancy?

What condition is associated with prolactinomas?

Galactorrhoea and Hyperprolactinaemia

Galactorrhoea is breast milk production unrelated to pregnancy or breastfeeding.
Prolactin, produced in the anterior pituitary gland (and other organs), stimulates milk production.
Dopamine inhibits prolactin secretion; antagonists (like antipsychotics) increase prolactin, causing galactorrhoea.
Dopamine agonists (e.g., bromocriptine, cabergoline) decrease prolactin.
Oestrogen and progesterone inhibit prolactin secretion during pregnancy.
Oxytocin stimulates breast milk excretion; milk production maximises post-birth due to oxytocin release and decreased oestrogen/progesterone.
Prolactin suppresses GnRH, lowering LH and FSH, potentially leading to altered reproductive function.

Prolactinomas

Prolactinomas are pituitary gland tumours that secrete excess prolactin.
They can be associated with MEN type 1 (autosomal dominant).
Prolactinomas can cause visual field defects due to optic chiasm compression.

Optic Chiasm Compression/Bitemporal Hemianopia

The optic chiasm is where optic nerve fibres cross.
Outer visual field fibres cross; inner visual field fibres remain on same side.
Larger pituitary tumours press on the optic chiasm, causing bitemporal hemianopia (loss of outer visual fields).

Treatment

Dopamine agonists lower prolactin and relieve symptoms of hyperprolactinaemia.
Trans-sphenoidal surgery (via nose/sphenoid bone) removes pituitary tumours.

This quiz explores galactorrhoea, a condition characterized by breast milk production unrelated to pregnancy, and its connection to hyperprolactinaemia. It also highlights prolactinomas, pituitary tumors that lead to excess prolactin secretion, and their potential effects on reproductive function and vision. Test your understanding of these important concepts in endocrinology.