<"I'm actually going to have my prolactin level taken tomorrow.  If all =
is well, my gyne just advised me to do all
that I could to cease my breasts from ever producing milk.  She told me =
to
take 1000 mg of Vitamin E per day, wear the tightest sports bra ever, =
ice my
nipples, avoid caffeine, and, basically, avoid all nipple stimulation.
That's what I have to go on right now... not very promising.  :-)  =
Thanks
again though.  Oh, she did say that there would be no point in my seeing
=
an
endocrinologist if my prolactin profile is normal.  Does that sound =
right?">

<I could to cease my breasts from ever producing milk.>

Yes, and take her chances with increased risk of breast and ovarian
cancer and osteoporosis, and for lack of full information make up her
mind to miss some of the most rewarding experiences in life! The lady
physician sounds paternalistic to me, and actually at a loss as to just
what's going on and how to explain it clearly to the young woman whose
life she is profoundly effecting. I wonder what Dr. Susan Love would say
about all this?

I might avoid caffeine on general principles, but before I took the rest
of the advice, I'd want the best second opinion I could get. And probably
a third, perhaps with the best breast surgeon in town, who would be
willing to thoroughly explain the specific tissue disease entity (duct
ectasia? Zuska's dsease?) that was the indication for surgery, plus the
pathology report to me.

It actually sounds as if the surgical condition may have little or
nothing to do with any endocrine causation. BOTOH, if I were the young
woman in question, since the endocrine question has been raised, I would
ask for a thorough "clean bill of health" from the endocrinologist,
especially with a history of anorexia.

I'd want to know what a prolactin profile consists of. Is it going to be
done fasting in the a.m.? Or just any time she gets to the lab in the
afternoon, after a couple of meals that day? Is more than one level going
to be drawn at different times and/or under each of these
fasting/non-fasting conditions? I don't know exactly the routine, but I
do know that prolactin levels differ under different conditions in the
same day in the same person. The endocrinologist is the person with the
most training to understand the pituitary function and its effect on the
breasts.

What would the gynecologist say if the young woman were having
unexplained vaginal bleeding and had gotten her reproductive hormones
checked by the endocrinologist and he told her not to bother with getting
a GYN checkup for the vaginal bleeding???

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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