Gonadal disorders Flashcards
What is the occasional expression of milk from the breasts called
Galactorrhoea
Describe a prolactinoma
Benign tumour of the pituitary gland
Describe the two problems that tumours of the pituitary gland can cause
Mechanical problems- local pressure due to its size, can present with headaches
Hormonal- over-secrete or under-secrete hormones
Explain how prolactinoma can lead to oligomenorrhea
Prolactin inhibits LH and FHS- no LH surge, no ovulation- no menstrual cycle. Hence oestrogen and progesterone are low
When do patients with a tumour of the pituitary gland notice symptoms
When it grows into the optic chiasm.
Describe how a tumour of the pituitary gland may cause bilateral hemianopia.
A tumour pressing on the optic chiasm from the adenohypophysis can cause bilateral hemianopia (cannot see out of the peripheries of both eyes) and causes prolactin release → galactorrhoea (milk ejection) - from the tumour stimulating the adenohypophysis.
Pressure exactly where optic nerves cross- peripheral vision loss
Pressure to lateral parts- nasal vision lost
Describe the formal perimetry test
Patient in front of wall that flashes light, mark where they can see light.
Dark spots- areas they can’t see
White spots in dark spots- where optic nerves enter the eye- blind spot.
How can we treat this problem
Dopamine- lowers prolactin- will reduce tumour size.
Cabergoline, bromocriptine
Describe the relationship between prolactin and GnRH
Prolactin inhibits GnRH so hormones stimulated by GnRH will not be created which can explain low levels of other hormones. o This may occur for example during nursing as the mother will not want to have another baby during the nursing of the current one so the prolactin inhibits the GnRH (and thus LH, FSH etc).
