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Endocrine Abstracts (2017) 48 CB12 | DOI: 10.1530/endoabs.48.CB12

SFEEU2017 Clinical Update Additional Cases (13 abstracts)

Investigating menstrual disturbance: a series of unfortunate events

Joannis Vamvakopoulos 1 , Andrew Bates 2 & Asad Rahim 2


1The Dudley Group NHS Foundation Trust, Dudley, West Midlands, UK; 2Heart of England NHS Foundation Trust, Birmingham, West Midlands, UK.


A 20-year-old lady presented to her GP with menstrual irregularity and worsening right-sided headaches with associated vomiting. Blood tests showed a mildly raised testosterone level and a markedly raised prolactin level, approximately 80% of which was macroprolactin (normal monomeric prolactin level). She was subsequently referred by her GP for an MRI Pituitary, which was reported as showing a 6-mm hypoenhancing lesion. Medical history includes migraines and hayfever; she was on no regular medications. She reported persistent menstrual disturbance, but no other symptoms, when seen in endocrine OP some 9 months later. There was no clinical evidence of hirsutism. Repeat blood tests confirmed normal monomeric prolactin in the context of macroprolactinaemia; as well as biochemical hyperandrogenism. Review of her MRI scan in our local MDT discounted the possibility of a pituitary lesion. Pelvic sonography confirmed the presence of multiple ovarian cysts. This case illustrates a series of unfortunate mishaps that can lead to over-investigation and misdiagnosis of menstrual disturbance.

Volume 48

Society for Endocrinology Endocrine Update 2017

Society for Endocrinology 

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