Serum Prolactin and Oestradiol Levels in Women with Cyclical Mastalgia

Abstract

Basal serum prolactin and serum oestradiol-17-beta concentrations were measured four times during one menstrual cycle in 20 women with severe cyclical mastalgia and normal to slightly fibroadenotic breasts. A group of 10 normal women who had never experienced mastalgia served as controls. Basal serum prolactin was significantly elevated in patients compared to normals, although within the normal range. Serum oestradiol concentrations did not differ in the two groups and were also within the normal range. A significant positive correlation between oestradiol and prolactin was found in patients and normals, but with larger prolactin levels in patients. The results point towards a prolactin secretory hypersensitivity for oestradiol in patients with cyclical mastalgia. Prolactin is considered a central factor in the eliciting of cyclical mastalgia.

Evaluation and Management of Breast Pain

“…§Hypothesis from studies assessing change in essential and saturated fatty acid levels in subjects with cyclic mastalgia compared with asymptomatic controls, suggesting effects on prostaglandins and receptor sensitivity to normal circulating hormones. 55,57 imbalances with potential causative roles in cyclic mastalgia have been investigated, and each has findings in support and opposition (Table 1 [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] ). One hormonal abnormality frequently detected in mastalgia is increased thyrotropin-induced prolactin secretion.…”

Management of Breast Pain

“…Other investigators, however, have failed to reproduce this finding 11 . Similarly, the role of oestradiol in cyclical mastalgia is uncertain, as some authors report normal levels, 10,12 while others have recorded elevated levels in the luteal phase 13 . Baseline serum prolactin levels are normal or slightly elevated among patients with cyclical mastalgia, 13,14 although prolactin stores are markedly elevated in this patient group 15 .…”

Bromocriptine therapy: Review of mechanism of action, safety and tolerability

“…Cyclical mastalgia is associated with menstrual cycle or premenstrual syndrome and most probably occurs during the luteal phase of menstrual cycle because of the increased water in breast stroma as a result of increasing hormone levels 134 . It is poorly localized, mostly felt as heaviness or soreness radiating to the axillae and arms with pathophysiology involving the rapid release of prolactin as a central factor in provoking the cyclical mastalgia 135–140 . Although non‐cyclic mastaglia is likely to be more focal than cyclic mastaglia and less commonly related to hormonal fluctuations and usually attributed to anatomic causes 141 .…”

“…134 It is poorly localized, mostly felt as heaviness or soreness radiating to the axillae and arms with pathophysiology involving the rapid release of prolactin as a central factor in provoking the cyclical mastalgia. [135][136][137][138][139][140] Although non-cyclic mastaglia is likely to be more focal than cyclic mastaglia and less commonly related to hormonal fluctuations and usually attributed to anatomic causes. 141 Therefore, in case of cyclical mastaglia, by normalizing the prolactin level the capability of bromocriptine to diminish the breast pain, tenderness, as well as heaviness has been confirmed by many researchers and even the beneficial effect of therapy has been reported to persist for 3 to 6 months even after cessation of treatment.…”