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Subject:
From:
Lisa Mandell <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 28 Mar 2002 00:11:00 -0500
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Hello all,

I am a LLLL and Lactnet lurker learning how much I don't know!

Regarding the thread on pap smears, Susan Stockwell
<[log in to unmask]> wrote:
>It would be interesting to know how widespread the refusal fo medical
help
>to women because they are lactating actually is.

Here's my story, for anyone who might be interested. My daughter weaned
last fall (4+ years). I had trouble conceiving her, and was anxious to
conceive again. My periods resumed at about one year postpartum, but when
I had no success conceiving I went to a reproductive endocrinologist when
my daughter was almost 3. I was pleasantly surprised that he didn't just
boot me out of his office as my daughter nursed during my consultation,
but after some blood work (normal, with a somewhat high prolactin of
40.6, which was dismissed by him since I was still bf), he basically said
he couldn't do anything for me until she weaned (he was, however,
supportive of my choice to nurture the one I had rather than give up bf
to try for another). Some time after that, my periods went from fairly
regular to very irregular (45-60 days apart, very low flow), and my
daughter was nursing less as she grew, so I felt there must be something
else going on. I went to my midwife, who did some blood work, which also
came back with somewhat high prolactin of 44. Again, the high prolactin
was dismissed as I was still bf. It seems I had read somewhere (can't
find the source) that prolactin levels are high in the first weeks/months
postpartum, but then decrease to normal levels as bf is established. I
had other signs that there was something strange, in that I continued to
leak, and to have occasional engorgement, through my daughter's 4th
birthday. I suspected a prolactinoma (benign microadenoma of the
pituitary gland). After my daughter weaned, I went back to the
reproductive endocrinologist, who again did blood work, and found that my
prolactin level was now 74! He sent me for an MRI, which confirmed that I
did indeed have a prolactinoma. Now I am taking bromocriptine (Parlodel)
to reduce my prolactin levels to normal in hopes of conceiving.

I am a little frustrated that neither of my HCP's thought to look further
at the high prolactin levels (although it wouldn't have changed the
course of action I took, it would have been nice to have more information
or an answer). I have tried (limited) searching for documentation on
prolactin levels through extended bf, and haven't found any. If anyone
knows of anything they would like to share with me, I would like to use
it to educate these HCP's. Perhaps this can also help moms some of you
might work with some day!

An addendum to tie back to the thread, I was also frustrated that I was
unable to get a mammogram for so long after age 40 (recommended age in US
-- or is it 35 now?) since no one in my area was willing to read a
mammogram of a lactating woman. After my daughter weaned I found it very
hard to schedule, since I was also trying to get pregnant. When I finally
went in about 2 months post-weaning, I mentioned this fact to the
technician. She practically refused to perform the mammogram, suggesting
that I had to wait 6 months, and was quite snide about how the
radiologist might not be able to see anything.

It's an education for us all. Thanks for listening. Hope my personal
story wasn't too off-topic.

Lisa Mandell
LLLL, southeastern PA, USA

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