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Prolactin Release Through Breast Stimulation in Non-lactating Women - Who Does Respond?

Not Applicable
Recruiting
Conditions
Breast Stimulation
Prolactin
Interventions
Other: Breast stimulation
Registration Number
NCT05208684
Lead Sponsor
University Hospital Tuebingen
Brief Summary

Prolactin is a multifunctional hormone which acts in different cell types rather than just modulating reproduction and lactation. One additional point is its action on glucose metabolism which is described especially in rodents. Prolactin affects proliferation, survival and insulin production of pancreatic beta cells in animal models. But also in human studies prolactin is linked to insulin action. Low systemic levels of prolactin are associated with increased prevalence of diabetes and while higher levels are associated with higher insulin sensitivity.

Acute metabolic effects of prolactin in young, healthy and non-lactating women should be accessed. Therefore, the induction of a transient increase of circulating prolactin levels is necessary to study the acute effects of this hormone on metabolic processes. This can most likely be achieved in non-pregnant and non-lactating women without pharmacological intervention.

As the main stimulus of prolactin release from the pituitary gland is the mechanical stimulation of the breast / nipple, like a suckling baby, stimulation by a breast pump might trigger prolactin release.

Due to other studies in this field, only a minority of women respond to breast stimulation with an increase in prolactin levels. Therefore, this pilot study will assess if an electric milk pump can stimulate prolactin release in non-lactating women. The second aim of the study is to identify factors which determine response and non-response to breast stimulation.

Prolactin will be measured in blood serum. The primary objective of this study is to identify women in whom a 30-minute breast stimulation causes a marked prolactin release. Response is defined as an increase at least twice the baseline value.

Second outcomes are the quantification and duration of prolactin increase as well as to detect differences in responders and non-responders. Therefore, demographic data as well as anthropometric data will also be assessed. A 10-minute electrocardiography and non-invasive measurement of resting energy expenditure by indirect calorimetry will also be performed. History of menstrual cycle, intake of contraceptive, parity and lactation experience will be recorded. Physical activity level and feeling of hunger will be assessed by questionnaires.

Feeling of hunger, resting energy expenditure, blood pressure, heart rate and body temperature will be assessed repeatedly to register differences before and after stimulation. Blood and urine samples will be assessed for safety.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
40
Inclusion Criteria
  • Women, aged between 18 and 45 years
  • premenopausal (women, who had menses at any time in the preceding 24 consecutive months)
  • BMI < 25 kg/m²
  • Ability to understand and voluntarily sign an informed consent document prior to any study related procedures
Exclusion Criteria
  • Type 1 or Type 2 diabetes
  • Intake of medication which may affect prolactin levels (e.g. Metoclopramide, Methyldopa, opiates, cimetidine), except birth control pill/hormonal contraception known hyperprolactinemia or hyperthyroidism
  • any other serious illness that might impact the results as judged by the investigator (e.g. malignant disease, coronary heart disease)
  • Pregnant / breastfeeding women (weaning at least 6 month ago)
  • plastic breast surgery (with detachment of milk ducts)
  • allergy to BPA-free plastic

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Breast stimulationBreast stimulationA 30-minute stimulation with moderate intensity by an electric milk pump (Elvie Pump) will be performed.
Primary Outcome Measures
NameTimeMethod
Prolactin release - yes/noSample collection will be from 0 to 90 minutes

The primary objective of this study is to identify women in whom breast stimulation causes a marked prolactin release. Response is defined as an increase at least twice the baseline blood value.

Secondary Outcome Measures
NameTimeMethod
Differences in subjects age1 minute

Differences between responders and non-responders will be assessed: differences in age by recording birth date

Differences in subjects BMI4 minutes

Differences between responders and non-responders will be assessed: differences in Body Mass Index by measuring height and weight of subjects and calculate the BMI

Differences in subjects menstrual cycle phase2 minutes

Differences between responders and non-responders will be assessed: differences in phase of menstrual cycle by recording the menstrual history

Differences in subjects heart rate variability parameters: time domain (beats per minute)10 minutes

Differences between responders and non-responders and within subjects will be assessed: differences in the time domain by two 10-minute 3 lead ECG measurements before and after stimulation

Differences in subjects body fat content3 minutes

Differences between responders and non-responders will be assessed: differences in body fat content by bioelectrical impedance analysis

Prolactin levelsSample collection will be from 0 to 90 minutes

Quantification, duration and trajectory of prolactin increase will be assessed by measuring prolactin levels in blood

Differences in subjects parity2 minutes

Differences between responders and non-responders will be assessed: differences in parity by recording family history

Differences in subjects stress reactionSample collection will be from 0 to 90 minutes

Differences between responders and non-responders will be assessed: differences in stress, measured by cortisol levels in blood

Changes in body temperature through stimulation1 minute

Register changes of body temperature before and after stimulation by an ear thermometer

Changes of Hypothalamic-Pituitary-Gonadal axis activity90 minutes

Changes in levels of Follicle stimulating hormone, Luteinizing hormone, estradiol and progesterone are assessed by measurement in blood

Differences in subjects heart rate variability parameters: Standard deviation of RR-intervals (SDNN)10 minutes

Differences between responders and non-responders and within subjects will be assessed: differences SDNN by two 10-minute 3 lead ECG measurements before and after stimulation

Differences in subjects physical activity level10 minutes

Differences between responders and non-responders will be assessed: differences physical activity level by questionnaire including the baecke index

Changes in feelings of hunger through stimulation10 minutes

Register change of feeling of hunger before and after stimulation by 15 questions on a five-point Likert scale survey about food cravings (FCQ-S)

Changes in heart rate through stimulation4 minutes

Register changes in heart rate before and after stimulation using an automatic instrument with a digital readout

Changes of Hypothalamic-Pituitary-Somatotropic axis activity90 minutes

Changes in Somatotropin and insulin-like growth factor 1 levels are assessed by measurement in blood

Changes of Hypothalamic-Pituitary-Thyroid axis activity90 minutes

Changes in levels of Thyroid-stimulating hormone, Triiodthyronine and Thyroxine are assessed by measurement in blood

Differences in subjects intake of hormonal contraception2 minutes

Differences between responders and non-responders will be assessed: differences in intake of hormonal contraception recording intake of medication

Differences in subjects heart rate variability parameters: Root Mean Square of successive RR interval differences (RMSSD)10 minutes

Differences between responders and non-responders and within subjects will be assessed: differences in RMSSD by two 10-minute 3 lead ECG measurements before and after stimulation

Differences in subjects heart rate variability parameters: Low to high frequency power ratio20 minutes

Differences between responders and non-responders and within subjects will be assessed: differences in LF/HF - Ratio by two 10-minute 3 lead ECG measurements before and after stimulation

Changes in blood pressure through stimulation4 minutes

Register changes in blood pressure before and after stimulation using an automatic instrument with a digital readout

Differences in subjects history of lactation2 minutes

Differences between responders and non-responders will be assessed: differences in history of lactation experience by recording history of lactation

Differences in subjects heart rate variability parameters: frequency domain parameters10 minutes

Differences between responders and non-responders and within subjects will be assessed: differences in low (LF) and high (HF) frequency power by two 10-minute 3 lead ECG measurements before and after stimulation

Changes in resting energy expenditure through stimulation30 minutes (each 15 minutes)

Register change of resting energy expenditure before and after stimulation by indirect calorimetry

Changes of Hypothalamic-Pituitary-Adrenal axis activity90 minutes

Changes in Corticotropin levels are assessed by measurement in blood

Changes of Hypothalamic-Pituitary-Prolactin axis activity90 minutes

Changes in Prolactin levels are assessed by measurement in blood

Trial Locations

Locations (1)

University Hospital Tuebingen, Otfried-Mueller Str. 10

🇩🇪

Tuebingen, Germany

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