1. All antipsychotics block dopamine receptors, so they can have some effect on endocrine and menstruation, more or less. Some varieties have less effect, such as olanzapine. Some have more, such as risperidone, sulpiride, or amisulpride. In addition, this effect is related to the size of the dose of the drug. Olanzapine does not have a significant effect on menstruation, but if the dose is high, the effect is more pronounced. A maintenance dose of pentoxifylline (20 mg per week) has almost no effect on menstruation, but if it is superimposed on the residual olanzapine that has not been excreted, it will show an effect. At this time, it is important not to use estrogen and progesterone supplements, etc. to create an “artificial cycle”. It is important to know that when exogenous estrogen and progesterone are injected into the body: on the one hand, they do cause the endometrial lining to grow and collapse, making it appear that you are having a period, but in fact it is a false period, just vaginal bleeding without ovulation, not a real period! On the other hand, they act as a ‘feedback inhibitor’, as if telling the pituitary gland “you have a lot of estrogen and progesterone in your body, you can rest now”, so the pituitary gland goes intoactive or even goes on strike. Experience shows that 1 month of medication can suppress pituitary function for more than 3 months. It would have taken only three or five months to go back to normal and get your period again after stopping the risperidone; now, it may be delayed for more than three months again; so there is no benefit. Due to the effect of antipsychotics, the concentration of estrogen and progesterone decreases; the brain tissue does not receive their feedback for a long time, so it mistakenly believes that “the fetus has been delivered” and secretes a lot of prolactin, hoping to prepare for breastfeeding. In fact, this is the brain tissue for the actual situation does not understand, made a “misjudgment”! 2, after taking various antipsychotic drugs, there will be varying degrees of “increased prolactin blood concentration” phenomenon; there are no exceptions, but the degree of high and low is different. There is no need for the patient to be nervous about this, and there is no need to deal with it. It is also remarkable that there is some swelling of the breast and possibly some lactation. There is absolutely no need to take any ‘bromocriptine’, otherwise the drug increases the DA and may cause the deterioration of the disease. After taking antipsychotics, the prolactin increases due to the blocked DA pathway, which will certainly reduce some libido requirements. There are no exceptions to the various antipsychotics, it is just the magnitude of the effect that varies. This is not the result of increased prolactin, both are “consequences”, not causes. Therefore, do not consider increased prolactin as the ‘culprit’. In contrast, maintenance doses of pentoxifylline have the least effect on sexual desire. One patient who was maintained on clozapine 50 mg and had no libido requirement, switched to pentoxifylline maintenance and things got better. In comparison, both olanzapine and pentofluvalidol are less influential. The impact of amisulpride is more significant, but we use a relatively short-term treatment, so it will not produce any after-effects problems. 3. Some patients reported “pituitary microadenoma” on the cranial X-ray, but in fact it only indicates more prolactin secretion. This is not a real tumor, so there is no need to be afraid and no need to deal with it. In one case, I was misdiagnosed by the neurosurgery department of a hospital and had a craniotomy to remove the so-called ‘tumor’. The schizophrenia did not improve, and the problem was finally resolved with olanzapine + MECT. Today, it has been maintained with pentoxifylline for more than ten years and everything is behaving normally.