Hypothalamic–pituitary–prolactin axis peptide (VIP). 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
Pituitary apoplexy brain and the spinal cord; the sample is obtained with a needle that is passed under local anesthetic into the spine. In pituitary apoplexy the results are typically normal, although abnormalities may be detected if blood from the pituitary has entered the subarachnoid space. If there is remaining doubt about the possibility of subarachnoid hemorrhage (SAH), a magnetic resonance angiogram (MRI with a contrast agent) may be required to identify aneurysms of the brain blood vessels, the most common cause of SAH. Professional guidelines recommend that if pituitary apoplexy is suspected or confirmed, the minimal blood tests performed should include