Hyperprolactinaemia

Hyperprolactinaemia is a common clinical problem with important effects on reproductive function. The condition is often drug-induced but potential pituitary disease, including micro- and macroprolactinoma and non-tumoural hyperprolactinaemia, requires evaluation. Treatment is usually with dopamine agonist drugs such as cabergoline, which suppress hyperprolactinaemia in most patients, and allow restoration of regular ovulation in women. Even large pituitary tumours usually display marked shrinkage with dopamine agonist treatment, hence pituitary surgery is rarely necessary. Women who become pregnant with dopamine agonists usually discontinue the drug during pregnancy, but have a small risk of significant pituitary enlargement.