wWHO Class III anovulation.

Tip 3: Never confuse between bioactivity of diff PRL molecules (monomer):-This rise may be due to innocuous immune reactive   so called big-prolactin -prolactin that are detected by the standard prolactin assays and give an incorrect impression of a problem. It is the very small molecules which are bioactive but what about PCO cases with excess PRL?? When Hyperprolactinaemia is associated with PCOS, the syndrome is characterized by adequate oestrogenisation, polycystic ovaries  on ultrasound scan and a withdrawal bleed after a Preogestogens challenge; the 'mineral density is usually normal.

Galactorrhoea may be found in up to one- third of hyperprolactinemic patients, although its appearance is not correlated with prolactin levels or with the presence of a tumour, approximately 5% present with visual field defects.

A prolactin-secreting microadenoma is usually associated with a moderately elevated prolactin (1500-4000 mud/L) and is unlikely to result in abnormalities on a lateral skull X-ray. Conversely, a microadenoma in concentrations of 4000 mud/L or more, and the figures may rise to 50,000 mud/L. Other causes of mild Hyperprolactinaemia include hypothyroidism, PCOS (occurs in 15% of cases up to 2500 mud/L) and