After my husband and I got married in 2017 the "when's the baby coming" questions started flooding in. This was before my diagnosis, but it was still pretty annoying. It's a really personal question. But I can understand that for a lot of people that's an easy conversation starter, and hey, a lot of couples do try for babies immediately after marriage.
#Fertility has always been a concern. For whatever reason I have always had this suspicion that I would have trouble getting pregnant or be unable to get pregnant even before I was diagnosed with #Adenomyosis and a #pituitarytumor. I don't know where this thought came from. I've cried over it. I've convinced myself that it's true. But really, I don't know if I can get pregnant. And I don't know if I can't either.
After my diagnosis' my negative thoughts amplified. High-levels of prolactin in the blood can cause infertility. Some women who have macroadenomas can lose their periods and ovulation may stop all together. Personally, I have experienced changes in menstruation. At first, I didn't know the cause of these changes. These changes included irregular periods and spotting almost daily. When these changes started happening I went back to my suspicions and started thinking that I wouldn't be able to get pregnant. It hasn't been easy to deal with. I'm not ready to start a family at this present moment, but this feeling of not being able to conceive and have a child hurts. And I don't even know what the truth is.
Research states that women who have small (small is not defined in the research) pituitary tumors can "usually" conceive and have a normal pregnancy. But that's only after what the researches call effective medical therapy. By medical therapy I assume that this journal is referencing the two primary medications used to treat prolactinomas - Cabergoline and Bromocriptine. Of the two, Bromocriptine has a longer history, and is considered the safer option of the two by physicians. My endocrinologist mentioned this, too. Both medications are considered safe for both the baby and mother during the early stages of pregnancy. But their safety throughout the entire pregnancy hasn't been established.
During pregnancy the pituitary enlarges and prolactin production increases in women who do not have pituitary disorders. Women who have prolactinomas run the risk of having their pituitary tumor enlarge, which can lead to other serious complications. Because of this, women who have pituitary tumors should see their endocrinologist every two months throughout the pregnancy.
Less than 3 percent of women with small prolactinomas have symptoms of tumor growth including vision problems and headaches. Women with large prolactinomas (again, large is not defined in the research) have a greater risk of tumor growth, said to be as high as 30 percent.
Medications like Cabergoline and Bromocriptine may be be reintroduced if a woman is experiencing symptoms of tumor growth such as headaches, vision changes, nausea, vomiting, excessive urination or thirst, or extreme lethargy. Weird, because all of these (minus the vision changes, to my knowledge) are symptoms of morning sickness. So, when does a woman who is living with a pituitary tumor of any size know that her symptoms are something more than morning sickness? Not to mention that the safety of these medications throughout an entire pregnancy haven't been established.
Now, the "when's the baby coming"question is a little more touchy for me. I get that the excitement of asking that question comes from a happy and sincere place. But, the person asking doesn't know that there are some serious risks that I have to think about. And not knowing if I can can conceive and carry a child is part of the equation too. I had to have a brutal conversation with my mom about this. She knew about my condition but didn't entirely understand the risks around pregnancy. Every time she would ask my mood would immediately switch and I would go to a dark place. It was like a reminder that I might not be able to conceive, that I might be broken despite all of my efforts to lead a healthy life. Then, I snapped at her. After explaining how it could potentially impact my health, namely vision impairment and possibly blindness, and how her asking the question made me feel she understood and was very sympathetic to my situation.
We're not ready for kids, yet. But our unique situation means that we have to start planning now.
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