Stress Reduction in Female Patients Can Lower Post-Surgical Pain by Targeting Prolactin Levels

Recent research from the University of Arizona has uncovered a promising approach to mitigate post-operative pain in women by targeting prolactin, a neurohormone influenced by psychological stress. Published in the Proceedings of the National Academy of Sciences, the study reveals that stress-induced elevation of prolactin contributes to increased pain sensitivity following surgery.

Prolactin, primarily known for its role in breast development and milk production, also impacts nerve cells responsible for pain transmission, especially in females who naturally have higher levels of this hormone. Elevated prolactin can enhance the activity of nociceptors, the nerve cells that send pain signals to the brain. Stress before surgery can trigger an influx of prolactin via disruption of normal hormonal regulation, creating a compounded effect that intensifies pain after procedures.

To explore this, the research team conducted experiments using female mouse models. They demonstrated that reducing prolactin levels prior to surgery significantly decreased post-operative pain. This was achieved through three methods: gene therapy techniques, administration of cabergoline—a dopamine receptor drug approved by the FDA that inhibits prolactin secretion—and a novel monoclonal antibody called PL 200,019 designed to block prolactin activity.

The findings suggest that preemptive treatment targeting prolactin could improve pain management strategies following surgery for women, potentially reducing dependence on opioids and minimizing the risk of chronic pain development. Dr. Frank Porreca, the lead researcher, emphasized the importance of addressing psychological stress before surgery, which can influence prolactin levels and pain outcomes.

Current medications like cabergoline, which are already approved for other indications, could be repurposed in clinical trials to serve as pre-surgical interventions. The monoclonal antibody is still under development but shows promise for future clinical use.

Overall, this research highlights the vital link between stress, hormonal regulation, and pain, paving the way for improved, personalized pain management approaches that could benefit many women undergoing surgical procedures.