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Pituitary
Published in: Pituitary 1/2020

01-02-2020 | Pituitary Adenoma

Prolactinomas and menopause: any changes in management?

Author: Yona Greenman

Published in: Pituitary | Issue 1/2020

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Abstract

Purpose

Treatment goals in prolactinomas are to correct hypogonadism, restore fertility and control tumor mass in case of macroadenomas. According to current guidelines, medical treatment of asymptomatic postmenopausal women is not indicated. The purpose of this study was to review the current literature pertaining to biological behavior of prolactinomas during menopause, likelihood of successful dopamine agonist withdrawal during this period and possible prolactin-mediated increased morbidity that could modify current management.

Methods

A comprehensive literature search including papers published until July 2019 was conducted using PubMed and Medline databases.

Results

Women with prolactinomas entering menopause have a higher chance of prolactin normalization of treatment compared with women in their reproductive years. Although most prolactin secreting adenomas diagnosed during menopause are large, they respond well to dopamine agonist treatment. Data directly linking hyperprolactinemia with an increased risk of cancer and cardiovascular and metabolic morbidity are inconsistent. There is no data indicating that correction of hyperprolactinemia improves clinical outcomes in asymptomatic patients bearing microadenomas.

Conclusion

There is no evidence that justifies changing current recommendations to withhold medical treatment of microprolactinomas in asymptomatic post-menopausal women. Macroprolactinoma patients should be treated according to standard clinical practice.
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Metadata
Title
Prolactinomas and menopause: any changes in management?
Author
Yona Greenman
Publication date
01-02-2020
Publisher
Springer US
Published in
Pituitary / Issue 1/2020
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-019-00998-0

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