Question:
My menstrual period is two month late and I am 37 years old.
This
happened before and my nipples were leaking milk.
I am
not pregnant.
I have
also sleep disturbances and I am concern about my problems with my
menstrual cycle.
Is there
any therapy or solution to my problem because I want to have children?
Thanks
Penny
Answer:
Dear
Penny,
High
prolactin levels can cause menstrual periods in women to be irregular
or stop, and can cause galactorrhea (abnormal breast milk production).
High
levels of prolactin (usually higher than 200 ng/mL) may mean a pituitary
gland tumor (prolactinoma) is present.
Prolactin-producing
tumors (prolactinomas) are benign tumors. In this type of pituitary
tumor, prolactin is overproduced.
Possible
causes of galactorrhea, or other types of nipple discharge include:
-Certain
drugs including oral contraceptives, Cimetidine, Methyldopa, Metoclopramide,
phenothiazines, Reserpine, tricyclic antidepressants, and Verapamil.
-A benign
tumor of the pituitary gland called prolactinoma.
-A benign
tumor of the breast duct called an intraductal papilloma. The type
of
nipple discharge produced by an intraductal papilloma is straw-colored
and is not milk or milk-like.
-Mammary
duct ectasia which occurs when a milk duct fills with fluid and widens
which causes the blocking of the duct with a thick and sticky fluid.
-Breast
trauma may also cause abnormal nipple discharge.
We would
recommend a prolactin test.
Normal
levels of prolactin in non-pregnant females are 2 - 29 ng/mL.
The drug
usually prescribed for High Prolactin Treatment is Bromocriptine (Parlodel
®).
It suppresses
the prolactin production, with a starting oral dosage of 1.25 to 2.5
mg a night, with the dosage increasing until levels are normal.
Ovulation
and menstruation generally return about six weeks after beginning
the medication. It is continued until pregnancy occurs. It is also
used to treat pituitary tumors. Unfortunately, prolactin levels usually
rise again when medication is discontinued.
Side
effects are mild and generally subside within a month.
