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 structures such as the optic nerve and the contents of the cavernous sinus are compressed. The raised pressure further impairs the blood supply to the pituitary hormone-producing tissue, leading to tissue death due to insufficient blood supply. It is recommended that magnetic resonance imaging (MRI) scan of the pituitary gland is performed if the diagnosis is suspected; this has a sensitivity of over 90% for detecting pituitary apoplexy; it may demonstrate infarction (tissue damage due to a decreased blood supply) or hemorrhage. Different MRI sequences can be used to establish when the apoplexy occurred, and the predominant form of damage