Neuroendocrine control of lactational infertility

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Abstract
Summary: An ever-changing secretory pattern of pituitary gonadotrophins and prolactin has been observed in puerperally lactating women. Studies in our laboratory suggest such changes are under neurogenic control via the breast. This in turn alters hypothalamic function. Endocrine profiles in lactating women obtained over 10 hours indicate that prolactin secretion and, to a lesser extent, LH secretion, are directly related to the duration and intensity of the suckling stimulus. Thus, lactation performance governs pituitary-ovarian function. Other investigators have shown that alterations in hypothalamic catecholamine turnover represents the interface between nipple stimulation and subsequent pituitary hormone secretion. Although further work is necessary to elucidate the exact neuroendocrine pathways involved, full lactation will effectively delay the restoration of cyclic gonadotrophin secretion and ovulation.