Prolactin Deficiency, Isolated

Isolated prolactin deficiency is a clear entity (Turkington, 1972) which may be an autosomal recessive trait. The affected females are generally healthy but are unable to nurse following parturition and have no detectable prolactin secretion after stimulation with phenothiazine. Falk (1992), who stated that only 3 cases had previously been reported, described a 36-year-old gravida 2, para 2 who had experienced normal childhood and adolescent development. After spontaneous menarche at age 13, her menses were grossly irregular, for which oral contraceptives were started at age 16. With the help of clomiphene, she conceived at the age of 30 and had an uneventful pregnancy which was followed, however, by failure of lactation during the puerperium. Three years later she again was successfully treated with clomiphene and went through an uncomplicated pregnancy except for the failure to establish lactation. There was no family history of problems with lactation or of irregular or absent menses. In addition to the 2 patients reported by Turkington (1972), Kauppila et al. (1987) reported a woman with puerperal alactogenesis who, despite undetectable immunoactive serum PRL measurements, had 2 normal pregnancies that were conceived without benefit of ovulation-inducing medications.