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Pituitary

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Prolactinomas and menopause: any changes in management?

  • Yona GreenmanEmail author
Article
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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.

Keywords

Prolactin Pituitary adenoma Prolactinoma Menopause Osteoporosis Breast cancer 

Notes

Funding

There was no funding for this paper.

Compliance with Ethical Standards

Conflict of interest

Yona Greenman declares that she has no conflict of interest.

Research involving animal and human participants

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of Endocrinology, Metabolism, Diabetes and HypertensionTel Aviv-Sourasky Medical CenterTel AvivIsrael
  2. 2.Tel Aviv UniversityTel AvivIsrael

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