Case study ( 3399 views as of March 26, 2019 )
Arlene is a 28-year-old graphic artist who has been noticing changes in her menstrual cycle recently. She visits her family physician to share her symptoms which include the absence of her menstrual period for the past 6 months, as well as occasional discharge of milky fluid from her breasts. She is concerned by these symptoms, and also wonders if this is affecting her fertility as she hopes to conceive in the near future.
Her family physician orders some blood tests and discovers that Arlene's prolactin level (the hormone that produces milk) is 10 times the normal level. She is referred to a local endocrinologist, and a subsequent MRI scan of her pituitary gland shows a lesion which is 1.3 cm in size. Arlene is diagnosed with a benign (non-cancerous) prolactin-secreting tumour of the pituitary gland, and she is started on oral medication to treat this. Shortly after starting treatment, she experiences a decrease in the breast discharge and her menstrual period resumes.
Along with routine follow-up and monitoring from her endocrinologist and family physician, Arlene would benefit from having a detailed vision exam, as pituitary gland tumours can press on the optic nerve and create visual symptoms. She should also consider lifestyle changes to help with her ongoing treatment and to prepare her body for pregnancy, such as quitting smoking, limiting alcohol intake, and prenatal yoga. She may wish to consult with a naturopathic doctor or a registered dietitian to learn about vitamins and supplements that could support her health goals, and a pharmacist to understand any possible interactions between vitamins and medications that she is taking.Author: Dr. Ronald Goldenberg