<prompt> A 35-year-old mother of two children, aged 5 and 6 years has had amenorrhoea and galactorrhoea for the past 12 months. Her serum prolactin level is 450 ngml. The most likely diagnosis isMenopausePituitary adenomaIntraductal papilloma of the breastsSheehans syndrome  <response>: In patients with both galactorrhea and amenorrhea, approximately two-thirds will have hyperprolactinemia; of those, approximately one-third will have a pituitary adenoma. A prolactin level as high as 150-200 ngmL is almost always due to a pituitary adenoma. Sheehans syndrome is characterised by amenorrhea and lactation failure not galactorrhea 