What should be considered in the examination of pituitary endocrine function in patients with amenorrhea?

Patients with amenorrhea need to undergo pituitary endocrine function tests, and the following factors should be considered during the examination:

1. Pituitary hormones are secreted and released in a pulsatile manner.

2. There are many factors that affect the secretion of pituitary hormones (especially prolactin), including the time of blood sample collection, whether or not the patient has eaten, whether or not the patient is under stress, whether the patient is asleep or awake, age and growth stage, and the effects of drugs.

3. When abnormal secretion of a certain pituitary hormone is suspected, other pituitary hormones should be comprehensively tested at the same time. If necessary, dynamic tests, such as rhythm tests, hormone excitation and inhibition tests, should be considered to assist in diagnosis. At the same time, it should be noted that functional tests and imaging tests must be combined to make a correct diagnosis.

4. Whether there are changes in target gland hormone levels and corresponding clinical symptoms, to explain the changes in the levels of a certain pituitary hormone, it is necessary to analyze it as a link in the hypothalamus-pituitary-target gland axis as a whole.

5. The normal range of pituitary hormones varies from laboratory to laboratory due to the different detection methods used. Therefore, the measurement results can only be based on the normal reference value range provided by the laboratory.

6. The heterogeneity of pituitary hormone components in the blood circulation can cause inconsistency between their immune activity and biological activity, resulting in discrepancies between laboratory tests and clinical manifestations.

7. Hormone values ​​may not be consistent with the size of the adenoma and clinical symptoms. The latter depends on the length of the disease course, the type of hormone, and whether the tumor undergoes degenerative and cystic changes.