MEDizzy - A 30-year-old woman is diagnosed with galactorrhea from both

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Endocrine System

A 30-year-old woman is diagnosed with galactorrhea from both breasts. She is not pregnant and has never been pregnant. The nipple discharge started two weeks ago, after she was in a car accident. She had a concussion and is still having headaches. The galactorrhea is most likely a result of which substance not reaching the pituitary gland?

ExplanationIn nonpregnant women, dopamine normally suppresses the release of prolactin by lactotrophs of the anterior pituitary. Dopamine, which is synthesized in hypothalamic neurons, reaches the anterior pituitary cells either by transport through long portal veins or by axonal transport within periventricular dopaminergic neurons along the pituitary stalk and through short portal vessels. Any disruption of these pathways, such as may be caused by traumatic brain injury, can lead to low pituitary dopamine and the consequent disinhibition of prolactin release. The resultant hyperprolactinemia leads to galactorrhea.