Clinical Case Study: Cessation of Menstrual Cycles in a 21-Year-Old College Student A 21-year-old female college student underwent menarche at 13 years of age. After 5 years of normal menses,

Clinical Case Study: Cessation of Menstrual Cycles in a 21-Year-Old College Student A 21-year-old female college student underwent menarche at 13 years of age. After 5 years of normal menses, her menstrual periods became less frequent and finally stopped (secondary amenorrhea). She does not use oral contraception nor is she sexually active, and a urine pregnancy test is negative. She also complains of headaches in the front of her head. During a physical examination by her family practitioner, a milky discharge can be expressed from both nipples. The clinician also finds that the patient has loss of temporal (peripheral) vision in both eyes. A pituitary gland tumor secreting prolactin is suspected. A magnetic resonance image (MRI) reveals the presence of a pituitary gland tumor, and when a blood test reveals a very high prolactin concentration, the diagnosis of hyperprolactinemia (excess prolactin in the blood) is confirmed. Guide Questions: Why does pregnancy cause amenorrhea? might be the effect of a prolactinoma in a man?

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