Breast Self Exam May Aid in Pituitary Tumor Diagnosis Thousand Oaks, CA – July 10, 2006 Manipulating the nipple and checking for discharge is an important yet often neglected step in a woman’s breast self exam. Discharge may be an indication of the presence of the most common type of pituitary tumor called a prolactinoma. According to the Pituitary Network Association, a prolactinoma is a benign tumor of the pituitary gland that produces a hormone called prolactin. Prolactin-producing tumors exist "silently" in up to 5-10 percent of the adult population. Symptoms of a prolactinoma are caused by too much prolactin in the blood (hyperprolactinemia) or by pressure of the tumor on surrounding tissues. Prolactin stimulates the breast to produce milk during pregnancy. After delivery of the baby, a mother's prolactin levels fall unless she breastfeeds her infant. Each time the baby nurses, prolactin levels rise to maintain milk production. In women, high blood levels of prolactin often cause infertility and changes in menstruation. In some women, periods may disappear altogether. In others, periods may become irregular or menstrual flow may change. Women who are not pregnant or nursing may begin producing breast milk. Some women may experience a loss of libido (interest in sex). Intercourse may become painful because of vaginal dryness. The normal prolactin level is < 20 ng/ml. In most women the tumors are detected when they are small (microadenomas) and the prolactin level is only moderately elevated (30 - 300 ng/ml). In contrast, in men prolactinomas are usually not detected until they are large (macroadenomas), most have prolactin levels over 500 ng/ml. A minority of patients with large tumors may have bleeding into the tumor (pituitary apoplexy) causing relatively sudden onset of headache, visual loss, double vision, and/or pituitary failure. The diagnosis of a prolactinoma is confirmed by demonstrating persistently elevated blood levels of prolactin. A prolactin level of over 150-200 ng/ml is almost always due to a prolactin secreting pituitary adenoma. In all patients with suspected pituitary tumors, a complete pituitary hormone evaluation should be performed. This testing is especially important in patients with potentially large tumors who are likely to have some degree of pituitary failure (hypopituitarism). It is important to note that moderate elevations of prolactin (30 - 200 ng/ml) can occur as a result of several other causes, which must be excluded prior to diagnosing a pituitary tumor. The most common causes are pregnancy or in the post-partum period, stress (discomfort, exercise, low blood sugar), low thyroid function (hypothyroidism), kidney failure, liver failure, medications (such as anti-ulcer and antidepressants), and "stalk effect". At one time, oral contraceptives were thought to contribute to the development of prolactinomas. However, this is no longer thought to be true. Patients with a prolactinoma treated with bromocriptine may also take oral contraceptives. Similarly, post-menopausal estrogen replacement is safe in patients with a prolactinoma treated with medical therapy or surgery. For a step-by-step self breast exam guide, visit www.WebMD.com. If nipple discharge is present, visit www.pituitary.org to find a specialized physician in your area.
Soma Communities - Central Texas Church Planter Residency | An Intensive Missional Community Residency What is Soma Central Texas? Soma central Texas is a family of city churches (currently City Life & Redeemer) that work together as a part of the Soma family to catalyze the planting of missional communities throughout central Texas. Residency Vision & Core Values Soma Commu
An Essay on the Environmental and Genetic Causes of Autism and the link to Vaccines By Dr. Mark Allan Sircus, Ac., OMD, DM (P) Director International Medical Veritas Association Doctor of Oriental and Pastoral Medicine For years I wrote about vaccines and many other issues surrounding pediatric care and most of this is evident in my new I wrote an essay about the Multiple Cause of