The action of PRL on Montgomery glands is a good hypothesis, however, there is no evidence to support the existence of PRL receptors on Montgomery glands, as they are just sebaceous glands. The truth is, both PRL and progesterone play a role in the differentiation and development of mammary glands. This study found that the existence of progesterone receptors mediated the differentiation and development of mammary glands. This meta-analysis provides more insight into the role of PRL in mammary gland development. I believe you might be under the impression that only estradiol can mediate gynecomastia in men. This is not the case. We can look to other pathologies as model, specifically hyperprolactinemia caused by a prolactinoma, which often leads to male galactorrhea. Likewise, many medications will cause gynecomastia and galactorrhea under similar hormonal control; antipsychotics, SSRIs, PPIs, H2 antagonists, spironolactone, etc.
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