Treatment of microprolactinomas

The treatment of choice is a dopamine agonist e.g. bromocriptine, cabergoline. Treatment generally needs to be continued until the menopause. However some patients appear to undergo remission after treatment for a number of years, especially after pregnancy. Endocrinological advice should be sought if a patient wishes to become pregnant whilst undertaking treatment with a dopamine agonist

If a patient is unable to tolerate dopamine agonist treatment then the patient should be considered for selective trans-sphenoidal surgery.

Reference

1. Peterssen S et al. Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement. Nat Rev Endocrinol. 2023 Dec;19(12):722-740.