A 44-year-old woman comes to the physician because she has not had her menses for 4 months. She has also had milky-white discharge from her nipples, frequent headaches, and blurry vision during the past 4 months. Menses had previously occurred at regular 30-day intervals and lasted for 4-5 days with moderate flow. She takes no medications. She has two children who are healthy and attend middle school. She is 163 cm (5 ft 4 in) tall and weighs 68 kg (145 lb); BMI is 26 kg/m2. Laboratory studies show an increased serum prolactin level, a normal TSH level, and an undetectable B-hCG concentration. MRI reveals a 6-mm pituitary adenoma. The patient refuses medical and surgical therapy as she is happy about not having menstrual periods. If left untreated, this patient is at greatest risk of developing which of the following?

Question

A 44-year-old woman comes to the physician because she has not had her menses for 4 months. She has also had milky-white discharge from her nipples, frequent headaches, and blurry vision during the past 4 months. Menses had previously occurred at regular 30-day intervals and lasted for 4-5 days with moderate flow. She takes no medications. She has two children who are healthy and attend middle school. She is 163 cm (5 ft 4 in) tall and weighs 68 kg (145 lb); BMI is 26 kg/m2. Laboratory studies show an increased serum prolactin level, a normal TSH level, and an undetectable B-hCG concentration. MRI reveals a 6-mm pituitary adenoma. The patient refuses medical and surgical therapy as she is happy about not having menstrual periods.  If left untreated, this patient is at greatest risk of developing which of the following?

Quizplus · Accepted Answer

Eductional Objective: Hyperprolactinemia suppresses secretion of GnRH, which leads to reduced estrogen in women.  Low estrogen levels are a risk factor for accelerated bone loss.

A 44-Year-Old Woman Comes to the Physician Because She Has