Prolactin production from proliferative phase leiomyoma

Daly, Douglas C.; Walters, Clifford A.; Prior, Jerilynn C.; Kuslis, Sally T.; Chapitis, Jane; Andreoli, John; Riddick, Daniel H.

doi:10.1016/s0002-9378(84)90445-9

Cited by 40 publications

(19 citation statements)

References 10 publications

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“…[22] This was suppressed by anti-prolactin antibodies and also progestrone showed suppressive effect. [23–26]…”

Section: Discussionmentioning

confidence: 99%

Predisposing factors for fibroids and outcome of laparoscopic myomectomy in infertility

Trivedi¹,

Abreo²

2009

J Gynec Endosc Surg

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Introduction:Fibroids are very common tumors affecting women for centuries, however surprising that no significant data is still available as to what could be the cause of fibroid? What could be the predisposing or risk factors? Does it has any impact on fertility? Outcomes of Laparoscopic myomectomy in infertility?Setting:Advanced Tertiary Gynecologic endoscopic unit.Aims and Objectives:1) What are the predisposing factors to develop fibroids? 2) Do fibroids lead to infertility? 3) What are the indications for removal of fibroids in infertility? 4) Is laparoscopic surgery better than open surgery? 5) Is the risk of rupture uterus more after laparoscopic myomectomy? 6) What is the success in terms of pregnancy rate after myomectomy? 7) What are the chances of abortions with or without myomectomy?Materials and Methods:A retrospective research study was carried out on 2540 women at the National Institute of Laser and Endoscopic Surgery and Aakar IVF Centre, Mumbai, a referral centre in India. This study was done over a period of 14 years. Women varied in age from 23 to 51 years and infertility of at least more than three years. The woman had fibroids from one to seventeen in number and two centimeters to eighteen centimeters in size which were either submucous, intramural, serosal, cervical or broad ligament. The women requiring hysteroscopic myoma resection were excluded in this study and Laparoscopic myomectomy done in woman other than infertility are also excluded from the study.Results:During the course of our study we found that the diet, weight, hypertension, habits had a bearing on incidence of fibroid. In one of the most promising research fact we found that fibroids itself produce prolactin and due to three times high level of aromatase had higher level of estradiol locally compared to normal myometrium. This was detrimental to fertility. A mild elevation of blood levels of prolactin usually in the range of 40 – 60 ng/ml was noticed in nearly 42% of the cases. Fibroids with infertility as a major complaint along with excessive vaginal bleeding in 33%, pain abdomen and dysmenorhea 10%, pressure symptoms in 3%, accidental finding of a large mass in 5% were the major indications for laparoscopic myomectomy. The pregnancy rate after removal of fibroids with active fertility treatment was 42 % and in donor oocyte IVF was 50%, abortion rate was 5%, 64% LSCS, 31% vaginal deliveries. There was no scar rupture in all pregnancies post laparoscopic myomectomy.Conclusion:Presence of fibroids in first degree female relative, predominantly red meat eating women, excess weight and high Blood pressure increased incidence of fibroids. Pregnancies & oral contraceptives decreased chances of fibroids. In infertile patient fibroids of significant size, multiple, had high local prolactin & aromatase level affecting fertility. Laparoscopic removal of fibroids increased pregnancy rate to 37.2% & 50% in donor oocyte IVF.

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“…[22] This was suppressed by anti-prolactin antibodies and also progestrone showed suppressive effect. [23–26]…”

Section: Discussionmentioning

confidence: 99%

Predisposing factors for fibroids and outcome of laparoscopic myomectomy in infertility

Trivedi¹,

Abreo²

2009

J Gynec Endosc Surg

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“…Although initially identified as a pituitary gland hormone, several studies have demonstrated that prolactin is also produced by uterine tissues, including the endometrium, myometrium, and uterine leiomyomas (Daly et al 1984;Maslar and Riddick 1979;Walters et al 1983). The significance of prolactin production in leiomyomas is not yet well defined; however, interest in this hormone has been stimulated by the finding that prolactin acts as a mitogen for vascular smooth muscle (Sauro and Zorn 1991).…”

Section: Growth Factors Identified In Fibroidsmentioning

confidence: 99%

“…In addition, in one study of myometrial and leiomyoma explant cultures, fibroid prolactin secretion was substantially greater than myometrial prolactin secretion (Rein et al 1990a). On the other hand, Daly et al found that estrogen enhanced the secretion of prolactin in fibroid tissue cultures, whereas progesterone exhibited a suppressive effect (Daly et al 1984). Because leiomyomas are mitotically active during the luteal phase, the inhibition of leiomyoma prolactin production by progesterone tends to cast some doubt upon the role of this hormone in fibroid growth.…”

Section: Growth Factors Identified In Fibroidsmentioning

confidence: 99%

Etiology and pathogenesis of uterine leiomyomas: a review.

Flake

Andersen

Dixon

2003

Environ Health Perspect

496

392

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Uterine leiomyomas, or fibroids, represent a major public health problem. It is believed that these tumors develop in the majority of American women and become symptomatic in one-third of these women. They are the most frequent indication for hysterectomy in the United States. Although the initiator or initiators of fibroids are unknown, several predisposing factors have been identified, including age (late reproductive years), African-American ethnicity, nulliparity, and obesity. Nonrandom cytogenetic abnormalities have been found in about 40% of tumors examined. Estrogen and progesterone are recognized as promoters of tumor growth, and the potential role of environmental estrogens has only recently been explored. Growth factors with mitogenic activity, such as transforming growth factor-β 3, basic fibroblast growth factor, epidermal growth factor, and insulin-like growth factor-I, are elevated in fibroids and may be the effectors of estrogen and progesterone promotion. These data offer clues to the etiology and pathogenesis of this common condition, which we have analyzed and summarized in this review.

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“…In vitro studies have demonstrated that PRL is produced by the human uterine tissues and that a functional PRL receptor is present in the uterus, which is capable of acting as a smooth muscle cell mitogen [11].…”

Section: Discussionmentioning

confidence: 99%

The Possible Role of Fluoxetine in Adenomyosis: An Animal Experiment with Clinical Correlations

Sengupta¹

2013

JCDR

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Introduction: Fluoxetine is a commonly prescribed drug which is used in the psychiatric practice and adenomyosis is a common medical problem in women of the reproductive age group.Objective: To explore the role of fluoxetine in the causation of adenomyosis.Methods: Female Wistar rats (n=18) were divided into three groups (group I (the control), group II and group III) and they were treated with normal saline and oral fluoxetine (4mg/kg and 8 mg/kg) respectively for 100 days. Periodic serum prolactin measurements and histopathological examinations of the uterine horns of all the rats were done at the end. Comparison of the mean serum prolactin levels between the patients (n=15) who were diagnosed with adenomyosis, the healthy age sex matched controls and the female patients (n=20) who received fluoxetine for more than 3 months, before and after the fluoxetine administration, was done separately. Appropriate (paired or unpaired) t tests were used for the data analysis.

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Prolactin production from proliferative phase leiomyoma

Cited by 40 publications

References 10 publications

Predisposing factors for fibroids and outcome of laparoscopic myomectomy in infertility

Predisposing factors for fibroids and outcome of laparoscopic myomectomy in infertility

Etiology and pathogenesis of uterine leiomyomas: a review.

The Possible Role of Fluoxetine in Adenomyosis: An Animal Experiment with Clinical Correlations

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