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Hyperprolactinaemia — DRCOG MCQ

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ModerateGynaecologyHyperprolactinaemiaDRCOG

A 29-year-old woman has 6 months of amenorrhoea and milky nipple discharge. Pregnancy test is negative. She has headaches but no visual disturbance. She takes no regular medication. What is the most appropriate investigation?

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Correct answer: E — Serum prolactin and thyroid function tests

Galactorrhoea with amenorrhoea suggests hyperprolactinaemia, and prolactin plus thyroid function tests are appropriate initial investigations. CA125 is not indicated for this presentation. Mid-luteal progesterone assesses ovulation but is not the priority when galactorrhoea is present. The pearl is that hypothyroidism can raise prolactin and should be checked.

Reference: NICE CKS amenorrhoea; NICE CKS prolactinoma