Increased local prolactin synthesis in the myometrium and endometrium as a probable cause of adenomyosis

Olga Malysheva, Maria I. Yarmolinskaya, Maria A. Shalina, Аndrey S. Glotov
In: Journal of obstetrics and women's diseases · 2026 · vol. 75(4) , pp. 36–44 · doi:10.17816/jowd713728 · W7214995950
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Abstract

BACKGROUND: Adenomyosis is a gynecological condition characterized by the abnormal presence of endometrial glands and stroma within the deeper layers of the myometrium. The role of prolactin in the development of adenomyosis was established earlier in experiments that showed that experimentally induced hyperprolactinemia, both local and systemic, can cause adenomyosis in animal models. Prolactin is also known to be synthesized locally in the female reproductive system, namely, in the endometrium and myometrium. AIM: The aim of this study was to evaluate prolactin gene expression levels in the tissues of the female reproductive system (endometrium, myometrium) in patients with adenomyosis compared with the control group and women with other gynecological diseases (endometriosis, uterine fibroids). METHODS: The real-time reverse transcription polymerase chain reaction method was used to evaluate prolactin gene expression in the endometrium of 104 patients with various hyperproliferative gynecological diseases, such as adenomyosis, uterine fibroids, and endometriosis, as well as in patients of the comparison group. Prolactin gene expression in the myometrium of 17 patients (8 women in the comparison group and 9 women with adenomyosis) was also analyzed. RESULTS: We found a significant increase in prolactin mRNA in the endometrium and myometrium of patients with adenomyosis. Some patients with uterine fibroids or endometriosis and women in the comparison group may experience sharp increases in prolactin mRNA, however, these changes are not systematic. CONCLUSION: The data obtained indicate the important role of local hyperprolactinemia in the pathogenesis of adenomyosis.

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