Hypothalamic–pituitary–prolactin axis Hypothalamic–pituitary–prolactin axis The hypothalamic–pituitary–prolactin axis (HPP axis), also known as the hypothalamic–pituitary–mammary axis or hypothalamic–pituitary–breast axis, is a hypothalamic–pituitary axis which includes the secretion of prolactin (PRL; luteotropin) from the lactotrophs of the pituitary gland into the circulation and the subsequent action of prolactin on tissues such as, particularly, the mammary glands or breasts. It is involved in lobuloalveolar maturation of the mammary glands during pregnancy and the induction and maintenance of lactation following parturition. Hormones that control the secretion of prolactin from the pituitary gland include dopamine ("prolactin-inhibiting factor", or "PIF"), estradiol, progesterone, thyrotropin-releasing hormone (TRH), and vasoactive intestinal
Pituitary apoplexy in association with particular conditions and situations; it is uncertain whether these were in fact causative. Amongst reported associations are surgery (especially coronary artery bypass graft, where there are significant fluctuations in the blood pressure), disturbances in blood coagulation or medication that inhibits coagulation, radiation therapy to the pituitary, traumatic brain injury, pregnancy (during which the pituitary enlarges) and treatment with estrogens. Hormonal stimulation tests of the pituitary have been reported to provoke episodes. Treatment of prolactinomas (pituitary adenomas that secrete prolactin) with dopamine agonist drugs, as well as withdrawal of such treatment, has been reported to precipitate apoplexy. Hemorrhage