If a woman tests her prolactin during non-pregnancy and finds an abnormal elevation, this may be an abnormal presentation due to hyperprolactinemia, or it may be considered to be caused by a pituitary tumor, or even due to precocious puberty, premature ovarian failure, or neuropsychiatric stimulation. Since pituitary prolactin is a peptide protein hormone secreted by the pituitary gland, it is often regulated by both hypothalamic inhibition and pituitary releasing hormones, so when there is a mild increase in pituitary prolactin, it may be due to excessive stress, poor rest, or even the use of drugs such as chlorpromazine, high doses of estrogen, and reserpine. It may also be due to ovarian decline and luteal insufficiency, and in patients with primary hypothyroidism and precocious puberty, it may also cause an abnormal increase in pituitary prolactin. If a woman is found to have an abnormally high pituitary prolactin, this is often considered to be a pituitary prolactinoma, which usually requires an MRI of the brain to confirm the diagnosis. Simple hyperprolactinemia, on the other hand, often causes amenorrhea and can lead to infertility, so it is often detected during infertility testing. In the case of women with mild hyperprolactinemia of the pituitary gland, the medication can be temporarily discontinued and instead reviewed again after a break.