Amenorrhea with lactation requires prevention of pituitary microadenoma

The gonad axis of the human body is dormant in childhood and people cannot perceive its existence. It begins to be active during puberty. The hypothalamus releases the inhibition of the pituitary gland, and the pituitary gland begins to secrete gonadotropin.

First, FSH (follicle stimulating hormone) causes the follicles in the ovaries to grow and secrete estrogen. Estrogen in turn causes the girl's nipples to bulge, breasts to grow, height to increase suddenly, and she grows into a graceful young girl; then menstruation comes. A few years later, the pituitary gland secretes LH (luteinizing hormone), which causes the follicles to mature and ovulate monthly, making the girl's menstruation come monthly and fertile. If pregnant, the pituitary gland secretes PRL (prolactin), which causes the breasts to secrete milk after delivery to feed the baby

It can be seen that the mysterious gonad axis, especially the pituitary gland on the axis, plays a vital regulatory role in the process of human reproduction. It can be said that without the pituitary gland, humans cannot complete the task of reproduction. Similarly, if there is a problem with the pituitary gland, it is difficult to complete the task of reproduction. One of the common problems is pituitary tumors, the most common of which is pituitary microadenoma, such as prolactinoma.

Most prolactinomas are small, with a diameter of <1 cm, and a few are >1 cm. This tumor is benign, grows slowly, can be carried for life, or may be asymptomatic and only discovered at autopsy. Although most of these tumors are small, the pituitary gland itself is very small, with a total weight of only 0.6 to 0.8 grams, about the size of a soybean, so a small prolactinoma can still present symptoms of being huge. Its common symptoms include:

(1) Oligomenorrhea or even amenorrhea As the disease progresses, symptoms of menstrual disorders such as luteal insufficiency, anovulation, oligomenorrhea, and amenorrhea may appear.

(2) Lactation. This is also a common symptom. In mild cases, the breasts need to be squeezed and milk will appear behind the nipple. Under a microscope, fat droplets can be seen in the milk, which is not bloody or watery. Lactation is mostly bilateral, but occasionally unilateral.

(3) Infertility: When PRL is slightly elevated, it can affect corpus luteum function and cause infertility. When it is severely elevated, it can affect ovulation, causing amenorrhea and infertility.

(4) Headache. If the prolactinoma is large, the head may become swollen or even painful.

(5) Blurred vision: When the tumor is large and compresses the optic nerve chiasm, visual field loss, shrinkage, or even blindness may occur.