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Categories of life events in patients with hyperprolactinemia (n ¼ 52) compared with controls (n ¼ 52). Number of individuals reporting at least one event in any category.
Source publication
Little is known about the relationship between recent life events and onset of hyperprolactinemia, despite the well-known effect of acute psychological stress on prolactin levels in healthy subjects. Recent life events in patients with hyperprolactinemia compared with healthy controls were investigated.
Case-control study.
Fifty-two consecutive pat...
Context in source publication
Context 1
... patients with hyperprolactinemia reported significantly more events rated as being of moderate, marked or severe negative impact compared with controls (Table 1). Table 2 displays three categories of events (13): (1) entrances (involving introduction of new people, such as marriage) and exits (involving departure of a person from the social field of the subject, such as the death of a close family member); (2) either socially desirable (e.g. promotion) or undesirable (e.g. ...
Similar publications
Prolactinomas are the most common secretory pituitary adenoma. They typically occur in women in the 3rd–6th decade of life and rarely in the pediatric population or after menopause. Most women present with irregular menses and/or infertility. Dopamine (DA) agonists, used in their treatment, are safe during pregnancy, but in most cases are discontin...
Objetive: To identify measures in early follow-up of men harboring macroprolactinomas, that will predict dynamics of PRL decrease and adenoma shrinkage.
A single center historical prospective study including a consecutive group of 71 men with pituitary macroadenomas (≥10 mm) and hyperprolactinemia (>7xULN) treated medically with cabergoline. Compar...
Purpose
Dopamine agonists (DAs) have long been the recommended first-line treatment for prolactinoma. Given the remarkable developments in surgical techniques, however, surgery is on the rise. We compared the treatment outcomes of patients with noninvasive prolactinomas receiving two different initial treatments (DAs and transsphenoidal surgery)....
Prolactinomas are solitary benign neoplasms and resistance to dopamine agonists occur in a small percentage of prolactinomas. Multiple pituitary adenomas are reported in less than 1% of pituitary adenomas and rarely result in resistant prolactinoma. We recently encountered an interesting patient of hyperprolactinemia with multiple pituitary microad...
Objective
Control of prolactin excess is associated with the improvement in gluco-insulinemic and lipid profile. The current study aimed at investigating the effects of pituitary surgery and medical therapy with high dose cabergoline (≥2mg/week) on metabolic profile in patients with prolactinoma resistant to cabergoline conventional doses (<2mg/wee...
Citations
... Альтернативні шляхи також УДК 616.661-053. 6 [2]. Гіперпролактинемія у дівчат призводить до аномальних маткових кровотеч, нерегулярних менструальних циклів, гіпо/оліго/аменореї, збільшення маси тіла, акне, ожиріння та гірсутизму [3]. ...
The second part of the presented article provides information on the activity of the pituitary, adrenal and sex glands in puberty and during stressful conditions. The relationship between hormones and neurotransmitters that ensure the activity of the body is described in detail, in particular, the effects of follicle-stimulating, luteinizing hormones, prolactin, somatotropic and adrenocorticotropic hormones, melatonin, cortisol, adrenaline and norepinephrine, estrogens, testosterone, etc. are given. The data of our own studies on the influence of physical activity of varying intensity (as a stress-modulating factor) on adolescents with different course of the puberty are presented. They confirmed a close relationship between the course of puberty and stress-dependent neuroendocrine factors, showed gender differences in the mechanisms of regulation during puberty. Particular attention in the article is focused on the main pathological conditions and diseases that can be provoked by severe or prolonged stress in adolescence. Features of the course of stress reactions in adolescents are associated with the still incomplete remodeling of regulatory structures. Along with increased vulnerability to stress factors, there is a high adaptive plasticity and vitality. Understanding the mechanisms of interaction between the neuroendocrine effects of stress and the restructuring of the body caused by puberty can contribute to the development of effective medical care measures to preserve the somatic and mental health of adolescents and maintain optimal resilience in adolescence.
... Consistently, increased baseline PRL levels have been found also in high-risk subjects who subsequently developed a psychotic disorder (Labad et al., 2015), suggesting that abnormalities in PRL secretion would even predate the psychotic experience. The release of PRL is part of the stress response (Levine and Muneyyirci-Delale, 2018) and is putatively linked to stress-induced alterations of dopaminergic and serotoninergic metabolism (Sonino et al., 2004). Thus, the increase in PRL might accountat least partiallyfor the concomitant increase in ACTH secretion (Levine and Muneyyirci-Delale, 2018). ...
Introduction. The role of anterior pituitary hormones – i.e., adrenocorticotropic hormone (ACTH), luteinizing and follicle stimulating hormones (LH and FSH), growth hormone (GH), prolactin (PRL), and thyroid-stimulating hormone (TSH) – in early schizophrenia and psychoses unclear. We thus performed a systematic review and meta-analysis on the blood concentrations of ACTH, LH and FSH, GH, PRL, and TSH in people with drug-naïve first-episode psychosis (FEP) as compared with healthy controls.
Methods. We searched Embase, MEDLINE, and PsycInfo for articles indexed until September 2022. Data quality was appraised. Random-effects meta-analyses were carried out, generating pooled standardized mean differences (SMDs). Between-study heterogeneity was estimated using the I2 statistic. Sensitivity and meta-regression analyses were performed.
Results. Twenty-six studies were included. Drug-naïve people with FEP, compared to healthy subjects, had higher blood concentrations of ACTH (k=7; N=548; SMD=0.62; 95%CI: 0.29 to 0.94; p<0.001; I2=60.9%) and PRL (k=17; N=1,757; SMD=0.85; 95%CI: 0.56 to 1.14; p<0.001; I2=85.5%) as well as lower levels of TSH (k=6; N=677; SMD=–0.34; 95%CI: –0.54 to –0.14; p=0.001; I2=29.1%). Meta-regressions did not show any moderating effect of age (p=0.78), sex (p=0.21), or symptom severity (p=0.87) on PRL concentrations in drug-naïve FEP. Available data were not sufficient to perform meta-analyses on FSH, LH, and GH.
Conclusions. Drug-naïve people with FEP have altered ACTH, PRL, and TSH blood concentrations, supporting the hypothesis that an abnormal anterior pituitary hormone secretion may be involved in the onset of schizophrenia and psychoses. Further research is needed to elucidate the role of pituitary hormones in FEP.
... Studying hyperprolactinemia, 52 consecutive patients (prolactinoma n = 33, idiopathic hyperprolactinemia n = 19) reported significantly more life events than their matched controls [37]. Within the complexity of the mechanisms involved, the findings indicate a potential role of stress in the pathogenesis of either prolactin-secreting pituitary tumors or idiopathic hyperprolactinemia [37]. ...
... Studying hyperprolactinemia, 52 consecutive patients (prolactinoma n = 33, idiopathic hyperprolactinemia n = 19) reported significantly more life events than their matched controls [37]. Within the complexity of the mechanisms involved, the findings indicate a potential role of stress in the pathogenesis of either prolactin-secreting pituitary tumors or idiopathic hyperprolactinemia [37]. ...
... In three studies [29,35,37] using Paykel's Interview for Recent Life Events [4], the rater made a judgment of the expected stressfulness of the event, when its full nature and particular circumstances are taken into account, ignoring the subjective reaction of the individual. Such rating (objective negative impact) encompasses both chronic stress and life events and has considerable similarities with the clinimetric definition of allostatic overload [12]. ...
The building of life stress, well expressed by the concept of allostatic load, plays an important part in all phases of endocrine illness. Allostatic load refers to the cumulative burden of both stressful life events and chronic stress. When environmental challenges exceed the individual ability to cope, allostatic overload ensues. Assessment of allostatic load/overload by clinical measurements including indices and rating scales, in addition to biomarkers, offers a characterization of the person's psychosocial environment that is missing from current formulations. Consideration of allostatic load in endocrinology may shed light on a number of clinical issues: interpretation of abnormal hormone values that lack explanations; coping with the various phases of illness; maladaptive illness behavior; response to treatment; presence of residual symptoms; health-damaging lifestyle habits. Addressing allostatic load calls for innovative models of endocrine outpatients with multidisciplinary organization of care, extended time for the interview, focus on rehabilitation. We provide an overview on the mechanisms of allostatic load, how it can be assessed, its potential role in endocrine disturbances, and how its consideration may lead to a needed innovation in patient care.
... Furthermore, characterizing prolactin levels it is also of interest, given that hyperprolactinemia can have serious adverse effects on general health such as amenorrhea (Klein, 2019), sexual disfunction (Drobnis and Nangia, 2017), osteoporosis (Samperi, 2019) and possibly breast cancer (De Hert, 2016;Ferrán Catalá-López, 2014). In addition, an increase in prolactin in situations of psychosocial stress has been described in healthy men and women (Lennartsson and Jonsdottir, 2011;Sonino, 2004). ...
Importance: Alterations in prolactin and cortisol levels have been reported in antipsychotic naïve patients with first episode psychosis (FEP). However, it has been studied in very small samples, and inter-group variability has never been studied before.
Objective: To provide estimates of standardized mean differences (SMD) and inter-group variability for prolactin, cortisol awakening response (CAR) and morning cortisol concentrations in antipsychotic naïve FEP (AN-FEP) patients and healthy controls (HC).
Data Sources: BIOSIS, KCI, MEDLINE, Russian Science Citation Index, SciELO, Cochrane, PsycINFO, Web of Science were searched from inception to February 28, 2022.
Study Selection: Peer-reviewed cohort studies that reported on prolactin or cortisol blood concentrations in AN- FEP patients and HC were included.
Data Extraction and Synthesis: Study characteristics, means and standard deviations (SD) were extracted from each article. Inter group differences in magnitude of effect were estimated using Hedges g. Inter-group variability was estimated with the coefficient of variation ratio (CVR). In both cases estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using meta-regression. PRISMA guideline was followed (No. CRD42022303555).
Main Outcomes and Measures Prolactin, CAR and morning cortisol blood concentrations in AN-FEP group in relation to HC group.
Results: Fourteen studies for prolactin (N=761 for AN-FEP group, N=687 for HC group) and twelve studies for morning cortisol (N=434 for AN-FEP group, N=528 for HC group) were included. No studies were found in CAR in AN-FEP patients. Mean SMD for prolactin blood concentration was 0.88 (95% CI 0.57, 1.20) for male and 0.56 (95% CI 0.26, 0.87) for female. As a group, AN-FEP presented greater inter-group variability for prolactin levels than HC (CVR=1.28, 95% CI 1.02, 1.62). SMD for morning cortisol concentrations was non-significant: 0.34 (95% CI -0.01, 0.69) and no inter-group variability significant differences were detected: CVR=1.05 (95% CI 0.91, 1.20). Meta-regression analyses for age and quality were non-significant. Funnel plots did not suggest a publication bias.
Conclusions and Relevance: Increased prolactin levels were found in AN-FEP patients. A greater inter-group variability in the AN-FEP group suggests the existence of patient subgroups with different prolactin levels. No significant abnormalities were found in morning cortisol levels. Further research is needed to clarify whether prolactin concentrations could be used as an illness biomarker.
... Epidemiyolojik çalışmalara göre idiyopatik hiperprolaktinemi tanısı öncesi süreçte kontrol grubuna göre hasta grubunda daha çok psikiyatrik yaşam olayı kaydedilmiştir. 23 Prolaktinin ruhsal stresle başa çıkma mekanizması olarak arttığı, dopamin ve seratonin sekresyonundaki nöroendokrin değişikliklerin fonksiyonel bir hiperprolaktinemiye yol açtığı düşünülmektedir. Prolaktin stres anında ACTH sekresyonu ve adrenal korteks ACTH duyarlılığının arttırılması, REM uykusunun düzenlenmesi gibi adaptif süreçlere katkı sağlamaktadır. ...
B ir organizmanın kararlı bir iç çevre ve dengede olması durumuna homeostaz denir. Stres, organizmanın homeostazis durumu üzerinde olumsuz etki yaratan, moleküler, hücresel, fizyolojik veya davranışsal düzeyde adaptasyonları tetik-leyen herhangi bir tehdit olarak tanımlanır. Allostazis ise fizyolojik değişiklikler ve dav-ranış değişiklikleri yoluyla stabiliteye ulaşma sürecidir. Stres durumu organizma üzerinde allostatik bir yük oluşturur. 1 "Stres" kavramı ilk olarak Kanadalı endokrinoloji uzmanı doktor Hans Selye tarafından tanımlanmıştır. Selye 1956 yılında stresi "Bede-nin, kendisine yönelik herhangi bir baskıya verdiği tepki" olarak tanımlamıştır. 2 Ruhsal stres ise öngörülebilir biyokimyasal, fizyolojik ve davranışsal değişikliklerin eşlik et-tiği duygusal bir deneyim olarak tanımlanır. Ruhsal stres, yaşamı tehdit eden veya trav-matik bir olaya verilen savaş ya da kaç tepkisinde olduğu gibi akut bir olay ya da meslek, iş yaşamı, kişilerarası ilişkiler nedeniyle oluşan düşük düzeyli kronik bir süreç olarak or-taya çıkabilir. Bireyin stresöre verdiği yanıt ve kişi üzerinde bıraktığı etki, bireysel başa çıkma becerileri, yaşam öyküsü, stres etkeninin şiddeti ve süresi gibi birçok faktöre bağ-lıdır. Akut veya kronik bir stresin sonucu olarak ortaya çıkabilecek kronik psikiyatrik bo-49 Stres ve Endokrinolojik Bozukluklar Stress and Endocrinological Disorders ÖZET Bir organizmanın kararlı bir iç çevre ve dengede olması durumuna homeostaz denir. Stres, or-ganizmanın homeostazis durumu üzerinde olumsuz etki yaratan, moleküler, hücresel, fizyolojik veya davranışsal düzeyde adaptasyonları tetikleyen herhangi bir tehdit olarak tanımlanır. Nöroendokrin sis-tem bir organizmanın adaptasyonunda önemli rol oynar. Ruhsal ve fiziksel bir stres durumunda hipota-lamusta kortikotropin salgılatıcı hormon (CRH) artar, aynı zamanda sempatomedüller sistem aktive edilir. CRH salınımı ile hipotalomus-hipofiz-adrenal (HPA) aksı aktive olur. Kronik ruhsal stres ve buna bağlı oluşan psikiyatrik hastalıklarda düzensiz HPA aksı aktivasyonu hiperkortizolemiye neden olur. Artan glukokortikoidler karaciğerde glukoneogenezi uyarır, iskelet kası ve yağ dokusu üzerindeki insü-lin etkisini inhibe eder, sonuçta viseral yağlanma ve metabolik sendrom komponentleri ortaya çıkar. Ay-rıca artan glukokortikoidler büyüme, tiroid, gonad aksı üzerinde olumsuz etki gösterir, osteoblastik aktiviteyi inhibe ederek osteoporoza neden olur. Bu makalede stres faktörünün neden olduğu endokri-nolojik bozukluklar üzerinde durulmuştur. Anah tar Ke li me ler: Stres; kortikotropin salgılatıcı hormon; endokrinolojik bozukluklar ABS TRACT The state of an organism in a stable internal environment and equilibrium is called home-ostasis. Stress is defined as any threat that has a negative impact on the homeostasis of the organism and triggers adaptations at the molecular, cellular, physiological or behavioral level. The neuroendocrine system plays an important role in the adaptation of an organism. In a state of psychological and physical stress, corticotropin-releasing hormone (CRH) increases in the hypothalamus, and at the same time, the sympathomedullary system is activated. With the release of CRH, the hypothalamic-pituitary-adrenal (HPA) axis is activated. In chronic mental stress, irregular HPA axis activation causes hypercortisolemia and related psychiatric diseases. Increasing glucocorticoids stimulate hepatic gluconeogenesis, inhibit insulin action on skeletal muscle and adipose tissue, resulting in visceral adiposity and metabolic syndrome components. In addition, increasing glucocorticoids act on growth, thyroid and gonad axis, inhibiting osteoblastic activity and causing osteoporosis. This article focuses on endocrinological disorders caused by stress factor.
... Prolactin. Prolactin is released in response to stress in humans and animals (Schedlowski et al., 1992;Theorell, 1992;Armario et al., 1996;Sobrinho, 2003;Sonino et al., 2004;Levin et al., 2018). Animal studies show that prolactin acts through kisspeptin neurons to suppress pulsatile GnRH secretion, and infertility due to hyperprolactinaemia can be reversed to some extent by treatment with kisspeptin (Sonigo et al., 2012). ...
Prolonged amenorrhoea occurs as a consequence of functional hypothalamic amenorrhoea (FHA) which is most often induced by weight loss, vigorous exercise or emotional stress. Unfortunately, removal of these triggers does not always result in the return of menses. The prevalence and conditions underlying the timing of return of menses vary strongly and some women report amenorrhoea several years after having achieved and maintained normal weight and/or energy balance. A better understanding of these factors would also allow improved counselling in the context of infertility. Although BMI, percentage body fat and hormonal parameters are known to be involved in the initiation of the menstrual cycle, their role in the physiology of return of menses is currently poorly understood. We summarise here the current knowledge on the epidemiology and physiology of return of menses.
OBJECTIVE AND RATIONALE
The aim of this review was to provide an overview of (i) factors determining the recovery of menses and its timing, (ii) how such factors may exert their physiological effects and (iii) whether there are useful therapeutic options to induce recovery.
SEARCH METHODS
We searched articles published in English, French or German language containing keywords related to return of menses after FHA published in PubMed between 1966 and February 2020. Manuscripts reporting data on either the epidemiology or the physiology of recovery of menses were included and bibliographies were reviewed for further relevant literature. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria served to assess quality of observational studies.
OUTCOMES
Few studies investigate return of menses and most of them have serious qualitative and methodological limitations. These include (i) the lack of precise definitions for FHA or resumption of menses, (ii) the use of short observation periods with unsatisfactory descriptions and (iii) the inclusion of poorly characterised small study groups. The comparison of studies is further hampered by very inhomogeneous study designs. Consequently, the exact prevalence of resumption of menses after FHA is unknown. Also, the timepoint of return of menses varies strongly and reliable prediction models are lacking. While weight, body fat and energy availability are associated with the return of menses, psychological factors also have a strong impact on the menstrual cycle and on behaviour known to increase the risk of FHA. Drug therapies with metreleptin or naltrexone might represent further opportunities to increase the chances of return of menses, but these require further evaluation.
WIDER IMPLICATIONS
Although knowledge on the physiology of return of menses is presently rudimentary, the available data indicate the importance of BMI/weight (gain), energy balance and mental health. The physiological processes and genetics underlying the impact of these factors on the return of menses require further research. Larger prospective studies are necessary to identify clinical parameters for accurate prediction of return of menses as well as reliable therapeutic options.
... Studies in women have shown that life experience can play a role in the etiology of prolactin perturbations (Assies et al., 1992;Sobrinho et al., 1984;Sobrinho, 2003;Sonino et al., 2004). External stressors, such as social conflict, a new job, death of a loved one, divorce, and academic and work place pressures increase the secretion of prolactin in predisposed individuals (Assies et al., 1992;Sobrinho et al., 1984;Sobrinho, 2003;Sonino et al., 2004). ...
... Studies in women have shown that life experience can play a role in the etiology of prolactin perturbations (Assies et al., 1992;Sobrinho et al., 1984;Sobrinho, 2003;Sonino et al., 2004). External stressors, such as social conflict, a new job, death of a loved one, divorce, and academic and work place pressures increase the secretion of prolactin in predisposed individuals (Assies et al., 1992;Sobrinho et al., 1984;Sobrinho, 2003;Sonino et al., 2004). Compared to controls, patients with hyperprolactinemia experienced a significantly higher number of stressful events in the months and years leading up to disease manifestation (Sonino et al., 2004). ...
... External stressors, such as social conflict, a new job, death of a loved one, divorce, and academic and work place pressures increase the secretion of prolactin in predisposed individuals (Assies et al., 1992;Sobrinho et al., 1984;Sobrinho, 2003;Sonino et al., 2004). Compared to controls, patients with hyperprolactinemia experienced a significantly higher number of stressful events in the months and years leading up to disease manifestation (Sonino et al., 2004). Studies also found that hyperprolactinemic women exhibit signs of anxiety (Sobrinho et al., 1984;Sobrinho, 2003;Sonino et al., 2004), including depression, hostility, and phobias (Yavuz et al., 2003). ...
Hyperprolactinemia is an endocrine disorder associated with infertility in many species, including elephants. In a recent survey of zoos accredited by the Association of Zoos and Aquariums (AZA), over half of African elephant females (N = 101) were not cycling normally, 30% of which exhibited hyperprolactinemia. We examined whether life experience and temperament predict ovarian cyclicity and circulating prolactin status in individual African elephant females. We hypothesized that, similar to humans, acyclicity and hyperprolactinemia in elephants will be associated with an apprehensive or fearful, anxious temperament, and an increased number of potentially challenging life events (transfers, deaths and births). Ninety-five adult African elephant females housed at 37 AZA institutions were included in this study. Blood samples were collected twice a month for 1 year to determine ovarian cycle (cycling, n = 44; irregular, n = 13; non-cycling, n = 38) and prolactin (normal, n = 44; low; n = 23; high; n = 28) status. Keeper ratings on a 6-point scale were obtained on 32 temperament traits in 85 of these elephants. We determined that giving birth and being exposed to herd mates entering the facility were positively associated with normal ovarian cycle and prolactin profiles. By contrast, age, serum cortisol, and an increased number of herd mates leaving a facility were negatively associated with both. Contrary to our hypothesis, hyperprolactinemia was associated with a popular and caring temperament rating, whereas consistently low prolactin was associated with a fearful, apprehensive temperament. These findings indicate that pituitary-ovarian function may be impacted by life history (cyclicity) and temperament (prolactin), which should be taken into consideration when making management decisions.
... Serum prolactin levels may rise in both physiologic (pregnancy, lactation, sleep, stress) and pathologic conditions (brain and systemic diseases). Literature data show that prolactinemia in patients with psychosis is influenced by gender, age [1,2], overt or subclinical hypothyroidism [3], psychotropic medication such as antipsychotics, antidepressants or buspirone [4,5], stress [6][7][8], and subtype of psychosis [9]. Under antipsychotic treatment, prolactin blood levels may rise up to 10 times the normal values [10]. ...
Background
Antipsychotic medication, stress, gender, and age are factors that influence prolactin levels in patients with psychosis. The aim of the study was to investigate the level of prolactin response to antipsychotic treatment in acute patients, taking into account the total duration of psychosis.
Methods and findings
The study was conducted on 170 acute patients with schizophrenia spectrum disorders and bipolar disorder. Subjects were divided into three subgroups according to the duration of the psychosis (less than 5 years, between 5 and 10 years and more than 10 years of disorder duration). The initial prolactin response under antipsychotic treatment was measured, while the severity of the psychiatric symptoms was assessed with the BPRS (Brief Psychiatric Rating Scale). Hyperprolactinemia was found in 120 (70.6%) patients, amongst which 80 (66.7%) were females and 40 (33.3%) were males. The average increase in prolactinemia was 2.46 times the maximum value in women, and 1.59 times in men. Gender (β = 0.27, p<0.0001), type of antipsychotic medication according to potency of inducing hyperprolactinemia (β = -0.23, p<0.003), and the duration of psychosis over 10 years (β = -0.15, p = 0.04) significantly predicted prolactin levels, when age, diagnosis, antipsychotic category (conventional/atypical/combinations of antipsychotics), and BPRS total scores were controlled for.
Conclusions and relevance
Prolactin levels in patients treated with antipsychotic medication appeared to depend on patients’ gender, on the type of antipsychotic medication according to potency of inducing hyperprolactinemia, and on the duration of the psychosis. An increase in prolactin levels was associated with female gender, while the use of prolactin sparing antipsychotics and a duration of psychosis over 10 years were associated with lower prolactin levels.
... 19 Depression, hostility, irritable mood, and anxiety are common in hyperprolactinemia. 18 Sonino et al. 20 have emphasized the role of emotional stress from recent life events in prolactinomas and idiopathic hyperprolactinemia. 21 The preferential treatment for prolactinoma is clinical and involves the use of dopamine agonists. ...
Objective:
To evaluate body dissatisfaction and distorted body self-image in women with prolactinoma.
Methods:
Body dissatisfaction and distorted body self-image were evaluated in 80 women with prolactinoma. All patients were in menacme, 34% had normal body mass index (BMI), and 66% were overweight. Most patients (56.2%) had normal prolactin (PRL) levels and no hyperprolactinemia symptoms (52.5%). The Body Shape Questionnaire (BSQ) was used to assess the patients’ dissatisfaction with and concern about their physical form, and the Stunkard Figure Rating Scale (FRS) was used to assess body dissatisfaction and distorted body self-image. The patients were divided according to PRL level (normal vs. elevated) and the presence or absence of prolactinoma symptoms.
Results:
The normal and elevated PRL groups had similar incidences of body dissatisfaction and distorted body self-image. However, symptomatic patients reported a higher incidence of dissatisfaction than asymptomatic patients. Distorted body self-image was less common among symptomatic patients.
Conclusion:
Symptomatic patients showed higher body dissatisfaction, but lower body self-image distortion. The presence of symptoms may have been responsible for increased body awareness. The perception of body shape could have triggered feelings of dissatisfaction compared to an ideal lean body. Therefore, a distorted body self-image might not necessarily result in body dissatisfaction in women with prolactinomas.
... It has been reported that patients with prolactinomas had been brought up under conditions of absent or violent fathers, significantly more so than control populations [3,[60][61][62][63]. Life events also often precede the clinical onset of prolactinomas [3,64]. These observations, taken together, support the hypothesis that exposure, early in life, to paternal deprivation may predispose some persons to, later, react to external stimuli developing a prolactinoma. ...
... We speculate that the activation of the maternal subroutine precedes and promotes the development of, at least, some prolactinomas. That would explain both the temporal relationship between life events and the clinical onset of the disease ( [5,64] and the relative independence between prolactin values and the amount of weight gained. ...
Weight gain at the outset of prolactinomas in many women is well documented. Yet, this symptom is absent from the clinical descriptions of the disease in textbooks and reviews. This omission is almost certainly due to the absence of a physiological explanation for the phenomenon, as prolactin is not a recognized fat promoting hormone. In this review we present the clinical evidence for a relationship between prolactin and fat accumulation and address some possible mechanisms involved. We put forward the hypothesis that prolactin is a component of a neuroendocrine program – maternal subroutine – aimed at optimizing the care of the young through the production of milk, promotion of maternal behavior and increase in the metabolic efficiency of the mother. These adaptations can enable her to face the extraordinary metabolic expenses of pregnancy and nursing, especially during times of suboptimal environmental conditions. We emphasize the uniqueness of prolactin in that it is a hormone that is tonically inhibited and which has its major effects on the regulation of an inter-individual (the mother – offspring dyad), rather than an intra-individual, system. This approach opens a window to consider the possibility of external events as regulators of this system. It also allows addressing a variety of hitherto unexplained findings reported in the literature. Examples include: association of prolactinomas with paternal deprivation and with stressful life events; pseudocyesis; acute life event-driven episodes of galactorrhea; episodes of rapid weight gain following a life event; prolactin surges (without associated cortisol surges) following some psychological stresses.
