Thyrotrophin-releasing hormone - a lactation-promoting agent?

Article Abstract:

The pituitary hormone prolactin stimulates the development of the breast and the production of milk during pregnancy. Sucking of the nipple shortly after birth stimulates the production of prolactin. Dopamine antagonists have been shown to increase the production of milk and improve disorders of lactation and the secretion of breast milk by increasing prolactin levels. Thyrotrophin-releasing hormone (TRH) has been shown in some studies to improve lactation disorders, and can be given by mouth, by injection into tissue underlying the skin, and in the form of nasal preparations. This study explored several aspects of treatment with a TRH nasal preparation for lactation disorders. The effects of TRH on milk production were assessed. Since lactation disorders may result from a deficiency in prolactin, the effects of sucking and TRH on prolactin levels were assessed as well. Finally, the effects of long-term treatment with TRH on levels of thyroid-stimulating hormone (TSH), and the thyroid hormones thyroxine and triiodothyronine, were evaluated. The study involved 19 women who had inadequate lactation five days after childbirth. Ten women were treated with TRH, whereas the remaining nine were given a placebo, or substance with no therapeutic effect. Sucking and TRH caused increases in prolactin levels in all women. Treatment with TRH resulted in an increase in milk production and prolactin levels, but did not alter TSH or thyroid hormone levels or cause hyperthyroidism, or increased activity of the thyroid gland. The findings suggest that repeated treatment with TRH given in a nasal preparation may improve lactation disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Physiological aspects, Thyrotropin releasing factor, Thyrotropin releasing hormone, Lactation disorders

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Lactation inhibition by the dopamine agonist CV 205-502

Article Abstract:

Prolactin is a hormone that is made in the brain by the pituitary gland. This hormone stimulates the secretion of milk from the breasts (lactation). During pregnancy other hormones (progesterone and estrogen) prevent prolactin from causing the milk to be released from the breasts. After the baby has been delivered the levels of progesterone and estrogen decrease and prolactin causes milk to be released from the breasts. For women who decide not to breast feed their babies, the release of milk from the breasts is undesired. In the 1970s, a drug called bromocriptine was found to be effective in preventing milk from being released from the breasts. This drug works by mimicking the effect of a chemical called dopamine. This chemical is made in the brain and it prevents milk from being released from the breasts by interfering with prolactin production. More recently, a new drug called CV 205-502 was developed. This drug prevents milk release from the breasts the same way that bromocriptine does. When this drug was given to 20 women who were bottle feeding their babies the levels of prolactin in the mothers' blood decreased and milk was not released from the breasts. Treatment with CV 205-502 caused symptoms of headache, nausea, vomiting, or insomnia in 10 women;Of the 10 women taking bromocriptine, three reported dizziness, nausea, and headache. The only side effect that was considered significant was a higher pulse rate in the standing position among the women receiving bromocriptine. CV 205-502 was as effective as bromocriptine in preventing milk release from the breasts. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Measurement, Prevention, Clinical trials

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Lactation inhibition by a single injection of a new depot-bromocriptine

Article Abstract:

Women who do not choose to breast feed may experience painful swelling of the breasts as they fill with milk. Bromocriptine is an agent that inhibits the production of prolactin, the hormone needed to produce milk during breast feeding. Since oral bromocriptine must be taken for two to three weeks to stop lactation completely and is associated with some side effects, women are less likely to complete the therapy. The first long-acting injectable form of the lactation inhibitor, depot-bromocriptine, had a carrier material that took too long to leave the body. A new carrier material was developed which has a shorter half-life and thus leaves the body more rapidly. The rapidly eliminated depot-bromocriptine was given to 61 women not wanting to breast feed. A single injectable dose of 40 milligrams was given to 30 women and a 50 mg dose was given to 31 women. Bromocriptine was increased in the blood after injection. Prolactin was inhibited for the total study period of 60 days after injection without developing rebound milk production. Side effects were experienced by six women receiving 50 mg and 10 women receiving the 40 mg dose. These included dizziness, nasal congestion, rash, and pain and redness at injection site. The single injection of the rapidly-eliminated injectable bromocriptine is a safe and effective method of inhibiting lactation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Dosage and administration

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