A 35-Year-Old Soldier With Galactorrhea and Amenorrhea

Ranjodh Singh Gill, MD

Disclosures

May 24, 2021

In addition to a detailed history and a thorough physical examination, the assessment of a patient with a pituitary mass should involve a complete evaluation of pituitary function, including both hypersecretion and deficiency.

In young females of reproductive age, the absence of menstruation is an important clue to the severity of the pituitary lesion and/or dysfunction.[1] If menstruation is intact, the pituitary function is most likely normal because gonadal function is usually lost first in a patient with a pituitary mass. In addition, when a female patient has intact menstruation, any elevation in the prolactin level tends to be mild.

However, all anterior pituitary axes that pertain to different hormones need to be assessed, namely gonadotropins, growth hormone, TSH, adrenocorticotropic hormone, and prolactin. Evaluation of posterior pituitary function is usually more focused and is guided by clinical features, such as polydipsia and polyuria, which indicate disruption of antidiuretic hormone.

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