Pituitary Tumor
Question
I have a similar question to some of the others. I am a healthy 26 year old despite hormone problems. I have never in my life had a cycle that was not drug induced. I was on Depo or birth control from age 16 to 21 and then went to see an endrocrinoligist when I still did not have cycles. I am currently taking Prometrium (100 mg/day, 14 days on, 14days off, on month 4), along with Fosamax (I’ve developed osteoporosis over the last couple years while mostly off of hormones), and various supplements for my adrenals, thyroid, etc. When I began all of this testing the doctors found my MRI reults to be fine, then in 2003 found a tumor in my pituitary. This year the reults show a decrease and is almost undetectable again. My prolactin levels have been normal for about two years now, but I still lack estrogen. What do you see as the primary problem or best way to treat this hormone imbalance? My boyfriend and I plan to marry and want to be able to start a family. Thanks for your help.
Amanda
Answer
Last Updated: December 2, 2013
If I am understanding your question correctly, you have had a pituitary tumor which has affected your pituitary hormones, which, in turn have affected your adrenal and thyroid glands. Just as you are needing to take adrenal and thyroid supplements, if you are deficient in estrogen you should take estrogen supplements. A young woman like yourself with a global pituitary problem (this is called panhypopitutarisn) should supplement all the deficient hormones. The best form of these hormones is bioidentical hormones, the same form the human body makes. Estrogen affects many organs, not only the bones. Although you are on Fosamax for the bones, there are benefits to estrogen beyond treating osteoporosis. The preferred type of estrogen replacement is a .1 mg. estradiol patch. The one I like best is the Vivelle dot. The patch is applied continuously. For progesterone replacement, Prometrium is a good choice. If you use supplemental estrogen, you should increase the dose of Prometrium to 200 mg. at bedtime, usually 10-12 days per month. A good estradiol level to aim for is 60-80 picograms, or a little higher.
Mary L. Davenport, M.D.
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