Hyperprolactinaemia and long-term lactational amenorrhoea

Area of Science:

• Reproductive Endocrinology
• Human Physiology
• Maternal Health

Background:

• Post-partum lactational amenorrhoea is a common phenomenon globally.
• The hormonal mechanisms regulating the return of menstruation and fertility after childbirth are complex.
• Elevated prolactin levels are known to suppress ovulation, but the precise endocrine interplay requires further elucidation.

Purpose of the Study:

• To investigate the relationship between serum hormone levels and lactational/menstrual status in post-partum women.
• To explore the role of prolactin in maintaining lactational amenorrhoea.
• To propose a sequence of endocrine events leading to the return of post-partum fertility.

Main Methods:

• Correlation of clinical data on lactation and menstruation with serum hormone measurements (prolactin, LH, FSH, oestradiol, progesterone).
• Study conducted on 74 breast-feeding mothers in Transkei.
• Analysis of endocrine profiles in women with varying menstrual and lactational histories.

Main Results:

• 66 out of 74 breast-feeding mothers exhibited elevated serum prolactin levels.
• 44 women were amenorrhoeic with minimal ovarian endocrine activity.
• Among menstruating lactating women, varying prolactin and ovarian hormone levels indicated different stages of ovarian follicular development and luteal activity; 3 were pregnant.

Conclusions:

• Results support the association between lactational amenorrhoea and hyperprolactinaemia.
• A potential sequence of endocrine events influencing the resumption of post-partum fertility is proposed.
• Further research into the hormonal regulation of post-partum cycles is warranted.