Microadenoma

Microadenoma: Role of oestrogen & serum PRL level:-In women who do not desire fertility, microadenoma -àexpectant management can be used for both 1) MRI diagnosed à macroadenomas and or  2) hyperprolactinemia  without an adenoma Question 1:-Where from PRL:-is Secreted from? Ans It is from  Lactotrophs of ant Pituitary which compromise about 15-25% of entire adenohyphophysis. 2) some other parts of brain 3) Lymphocytes (PRL- helps in immune functions of the body).4) Controls autocrine & paracrine functions of many cells.5) like growth hormone and HPL  it also control- angiogenic activities. 6) May have actions on Breast Ca & prostate ca.

Question: 2 how PRL come from?? Secretion of Prolactin: - its tonic secretion is controlled by PIF (Dopamine). PRL release from adenohyphophysis:-Circadian Rhythm: Diurnal variation:-

Pulsatile release: In late follicular phase 14 pulses per day and in late luteal phase the total pulse per day is 9/ daily. Each pulse last for 70 minutes and with an inter-pulse interval of about 70 minutes.

Question 3;-Ans:--Which natural agents promote PRL biosynthesis?? Ans:-It is Oestrogen that  promotes synthesis and release of PRL. In ovulatory cycles in late follicular phase when E2 is high PRL will be high.

But progesterone depresses serum PRL, - The intake of OCP may cause rise of PRL and sometimes inappropaite location (Galactorrhoea)  but the serum level comes down to normal after 3-4 days.

Question 3-:-Ans;-Factors causing rise of prl: - Stress, Smell (Olfaction), Audition-Noise, But Chr, stress & exercise do not cause rise of PRL. Breast stimulation. Venepuncture.

Q 4:-When to collect samples? Mid morning, no physical examination.

Suppose report come high: What next?

Is she already pregnant: - In preg due to high rise of E2à start rising at 6-8 weeks of preg—surprisingly, regardless of breast feeding PRL comes to normal 6 weeks after delivery. So Postpartum contraception should begin after 6 weeks as Ovulation can occasionally occur