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Hyperprolactinaemia — DRCOG MCQ

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ModerateGynaecologyHyperprolactinaemiaDRCOG

A 30-year-old woman has secondary amenorrhoea and bilateral milky nipple discharge. Pregnancy test is negative and she takes no antipsychotic medication. What is the most appropriate investigation?

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Correct answer: D — Measure serum prolactin and thyroid function

Galactorrhoea with amenorrhoea suggests hyperprolactinaemia, so prolactin and thyroid function should be checked after excluding pregnancy. Hypothyroidism can raise prolactin and cause menstrual disturbance. CA125, cervical cautery and doxycycline do not address the endocrine presentation. Persistent marked prolactin elevation may require pituitary imaging.

Reference: NICE CKS amenorrhoea; NICE CKS hyperprolactinaemia