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Prolactin and the return of ovulation in breast-feeding women

Published online by Cambridge University Press:  27 September 2011

Barbara A. Gross  and
Creswell J. Eastman
Barbara A. Gross
Affiliation:
Endocrine Unit, Department of Medicine, Westmead Centre, Westmead, NSW, Australia
Creswell J. Eastman
Affiliation:
Endocrine Unit, Department of Medicine, Westmead Centre, Westmead, NSW, Australia
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Summary

Cross-sectional studies in Australia and the Philippines and a longitudinal prospective study in a selected Australian sample of breast-feeding mothers have shown that basal serum prolactin (PRL) concentrations are elevated during 15–21 months of lactational amenorrhoea.

A predictive model of serum PRL levels and return of cyclic ovarian activity during full breast-feeding, partial breast-feeding and weaning has been developed from the results of breast-feeding behaviour and serum PRL, gonadotrophin and oestradiol measurements in 34 mothers breast-feeding on demand for a mean of 67 weeks.

Breast-feeding patterns influence serum PRL levels. Important factors during full breast-feeding are the age of the baby, the longest interval between feeds at night and total 24-hr suckling time, and following the introduction of supplements, the mean interval between feeds, together with the total 24-hr suckling time and the number of solid supplements per day.

The precise mechanisms whereby breast-feeding regulates cyclic ovarian activity remain unknown. Gonadotrophin secretion appears to be quantitatively normal, but qualitative changes, secondary to altered hypothalamic activity, may be the most important factor. A direct inhibitory effect of PRL on ovarian follicular development and steroidogenesis remains possible.

Ovulation with a normal luteal phase is probable for 30% of breast-feeding mothers before the first menses, but is unlikely before 6 months, provided breast-feeding is frequent day and night.

Measurement of serum PRL is a sensitive index of the return of menstruation and fertility during lactation in the population studied.

Type
Research Article
Information
Journal of Biosocial Science , Volume 17 , supplement S9: Breast-feeding and Fertility , 1985 , pp. 25 - 42
Copyright
Copyright © Cambridge University Press 1985

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References

Andreassen, B. & Tyson, J.E. (1976) Role of the hypothalamic-pituitary-ovarian axis in puerperal infertility. J. clin. Endocr. Metab. 42, 1114.CrossRefGoogle ScholarPubMed
Billings, J.J., Billings, E.L., Brown, J.B. & Burger, H.G. (1972) Symptoms and hormonal changes accompanying ovulation. Lancet, i, 282.CrossRefGoogle Scholar
Billings, J.J., Billings, E.L. & Catarinich, M. (1977) The Atlas of the Ovulation Method. Advocate Press, Melbourne.Google Scholar
Bonnar, J., Franklin, M., Nott, P. & Mcneilly, A. (1975) Effect of breast-feeding on pituitary ovarian function after childbirth. Br. med. J. 4, 82.CrossRefGoogle ScholarPubMed
Brown, J.B., Harrisson, P. & Smith, M.A. (1985) A study of returning fertility after childbirth and during lactation by measurement of urinary oestrogen and pregnanediol excretion and cervical mucus production. J. biosoc. Sci. Suppl. 9, 5.CrossRefGoogle ScholarPubMed
Buchanan, R. (1975) Breast-feeding—Aid to Infant Health and Fertility Control. Population Reports Series J, No. 4, 49. George Washington University Medical Center, Washington, DC.Google Scholar
Corenblum, B., Pairaudeau, M. & Shewchuk, A.B. (1976) Prolactin hypersecretion and short luteal phase defects. Obstet. Gynec. 47, 486.Google ScholarPubMed
Del Pozo, E., Wyss, H., Lancranjan, I., Obolensky, W. & Varga, L. (1976) Prolactin-induced luteal insufficiency and its treatment with bromocriptine: preliminary results. In: Ovulation in the Human, p. 297. Edited by Crosignani, P. G.. Academic Press, London.Google Scholar
Del Pozo, E., Wyss, H., Tolis, G., Alcanitz, J., Campana, A. & Naftolin, F. (1979) Prolactin and deficient luteal function. Obstet. Gynec. 53, 282.Google ScholarPubMed
Delvoye, P., Delogne-Desnoeck, J. & Robyn, C. (1976) Serum prolactin in long lasting lactational amenorrhoea. Lancet, ii, 288.CrossRefGoogle Scholar
Delvoye, P., Delogne-Desnoeck, J., Uwayitu-Nyampeta, & Robyn, C. (1977) Time-course of physiological hyperprolactinaemia during two years lactation. Clin. Endocr. 7, 257.CrossRefGoogle ScholarPubMed
Demura, R., Ono, M., Demura, H., Shizume, K. & Oouchi, H. (1982) Prolactin directly inhibits basal as well as gonadotropin-stimulated secretion of progesterone and 17-beta-estradiol in the human ovary. J. clin. Endocr. Metab. 54, 1246.CrossRefGoogle ScholarPubMed
Diaz, S., Peralta, O., Juez, G., Salvatierra, A.M., Casado, M.E., Duran, E. & Croxatto, H.B. (1982) Fertility regulation in nursing women: I. The probability of conception in full nursing women living in an urban setting. J. biosoc. Sci. 14, 329.CrossRefGoogle Scholar
Duchen, M.R. & Mcneilly, A.S. (1980) Hyperprolactinaemia and long-term lactational amenorrhoea. Clin. Endocr. 12, 621.CrossRefGoogle ScholarPubMed
Flynn, A.M. & Lynch, S.S. (1976) Cervical mucus and identification of the fertile phase of the menstrual cycle. Br. J. Obstet. Gynaec. 83, 656.CrossRefGoogle ScholarPubMed
Gross, B.A. (1984) Breastfeeding and Fertility: The Role of Prolactin. PhD thesis, University of Queensland, Australia.Google Scholar
Gross, B.A. & Eastman, C.J. (1979) Prolactin secretion during prolonged lactational amenorrhoea. Aust. N. Z. J. Obstet. Gynaec. 19, 95.CrossRefGoogle ScholarPubMed
Gross, B.A. & Eastman, C.J. (1983) Effect of breast-feeding status on prolactin secretion and resumption of menstruation. Med. J. Aust. 1, 313.CrossRefGoogle ScholarPubMed
Gross, B.A., Eastman, C.J., Bowen, K.M. & Mcelduff, A. (1979) Integrated concentrations of prolactin in breast-feeding mothers. Aust. N. Z. J. Obstet. Gynaec. 19, 150.CrossRefGoogle ScholarPubMed
Gross, B.A., Haynes, S.P., Eastman, C.J., Guzman, V.B. & del Castillo, L.V. (1980) A cross-cultural comparison of prolactin secretion in long-term lactation. Prog, reprod. Biol. 6, 179.Google Scholar
Habicht, J.P., Butz, W.P., Meyers, L. & Davanzo, J. (1985) The contraceptive role of breastfeeding. Popul. Stud, in press.CrossRefGoogle Scholar
Harrisson, P.M. (1973) Returning fertility during lactation. In: Proceedings of the Ovulation Method Workshop. Responsible Parenthood Association, Sydney, Australia.Google Scholar
Hilgers, T.W., Abraham, G.E. & Cavanagh, D. (1978) Natural family planning. 1. The peak symptom and estimated time of ovulation. Obstet. Gynec. 52, 575.Google ScholarPubMed
Howie, P.W., Mcneilly, A.S., Houston, M.J., Cook, A. & Boyle, H. (1981) Effect of supplementary food on suckling patterns and ovarian activity during lactation. Br. med. J. 283, 757.CrossRefGoogle ScholarPubMed
Howie, P.W., Mcneilly, A.S., Houston, M.J., Cook, A. & Boyle, H. (1982) Fertility after childbirth: infant feeding patterns, basal PRL levels and post-partum ovulation. Clin. Endocr. 17, 315.CrossRefGoogle ScholarPubMed
Jones, G.S. (1976) The luteal phase defect. Fert. Steril. 27, 351.Google ScholarPubMed
Li, C.C. (1975) Path Analysis—a Primer. Boxwood Press, Pacific Grove, California.Google Scholar
Mcnatty, K.P., Sawers, R.S. & Mcneilly, A.S. (1974) A possible role for prolactin in control of steroid secretion by the human graafian follicle. Nature, Lond. 250, 653.CrossRefGoogle ScholarPubMed
Noel, G.L., Suh, H.K. & Frantz, A.G. (1974) Prolactin release during nursing and breast stimulation in postpartum and non-postpartum subjects. J. clin. Endocr. Metab. 38, 413.CrossRefGoogle Scholar
Pascal, J. (1969) Quelques Aspects de la Physiologie du Postpartum. Apports de la Courbe Thermique Basale. Applications a la Regulation de Naissances. MD thesis, University of Nancy, France.Google Scholar
Perez, A., Vela, P., Masnick, G.S. & Potter, R.G. (1972) First ovulation after childbirth: the effect of breast-feeding. Am. J. Obstet. Gynec. 114, 1041.CrossRefGoogle ScholarPubMed
Rolland, R., Lequin, R.M., Schellekens, C.A. & Dejong, F.H. (1975) The role of prolactin in the restoration of ovarian function during the early post partum period in the human female. I. A study during physiological lactation. Clin. Endocr. 4, 15.CrossRefGoogle Scholar
Rosa, F.W. (1975) The Role of Breastfeeding in Family Planning. Protein–Calorie Advisory Group Bulletin, Vol. 5 No. 3. United Nations, New York.Google Scholar
Schallenberger, E., Richardson, D.W. & Knobil, E. (1981) Role of prolactin in the lactational amenorrhea of the rhesus monkey (Macaca mulatto). Biol. Reprod. 25, 370.CrossRefGoogle Scholar
Seppala, M., Hirvonen, E. & Ranta, T. (1976) Hyperprolactinaemia and luteal insufficiency. Lancet, i, 229.CrossRefGoogle Scholar
Sherman, B.M. & Korenman, S.G. (1974a) Measurement of plasma LH, FSH, estradiol and progesterone in disorders of the human menstrual cycle: the short luteal phase. J. clin. Endocr. Metab. 38, 89.CrossRefGoogle ScholarPubMed
Sherman, B.M. & Korenman, S.G. (1974b) Measurement of serum LH, FSH, estradiol and progesterone in disorders of the human menstrual cycle: the inadequate luteal phase. J. clin. Endocr. Metab. 39, 145.CrossRefGoogle ScholarPubMed
Strott, C.A., Cargille, C.M., Ross, G.T. & Lipsett, M.B. (1970) The short luteal phase. J. clin. Endocr. Metab. 30, 246.CrossRefGoogle ScholarPubMed
Tolis, G., Guyda, H., Pillorger, R. & Friesen, H.G. (1974) Breast-feeding: effects on the hypothalamic pituitary gonadal axis. Endocr. Res. Comm. 1, 293.CrossRefGoogle Scholar
Tyson, J. (1977) Nursing and prolactin secretion: principal determinants in the mediation of puerperal infertility. In: Prolactin and Human Reproduction, p. 97. Edited by Crosignani, P. G. and Robyn, C.. Academic Press, London.Google Scholar
Tyson, J.E., Carter, J.N., Andreassen, B., Huth, J. & Smith, B. (1978) Nursing-mediated prolactin and luteinizing hormone secretion during puerperal lactation. Fert. Steril. 30, 154.CrossRefGoogle ScholarPubMed
Tyson, J.E. & Friesen, H.G. (1973) Factors influencing the secretion of human prolactin and growth hormone in menstrual and gestational women. Am. J. Obstet. Gynec. 116, 377.CrossRefGoogle ScholarPubMed
Tyson, J.E., Friesen, H.G. & Anderson, M.S. (1972a) Human lactational and ovarian response to endogenous prolactin release. Science, N.Y. 177, 897.CrossRefGoogle ScholarPubMed
Tyson, J.E., Hwang, P., Guyda, H. & Friesen, H. (1972b) Studies of prolactin secretion in human pregnancy. Am. J. Obstet. Gynec. 113, 14.CrossRefGoogle ScholarPubMed
Van Ginneken, J.K. (1974) Prolonged breastfeeding as a birth spacing method. Stud. Fam. Plan. 5, 201.CrossRefGoogle ScholarPubMed
Van Ginneken, J.K. (1977) The chance of conception during lactation. J. biosoc. Sci. Suppl. 4, 41.CrossRefGoogle Scholar
Veldhuis, J.D. & Hammond, J.H. (1980) Oestrogens regulate divergent effects of prolactin in the ovary. Nature, Lond. 284, 262.CrossRefGoogle ScholarPubMed