Management of prolactinoma prior to, during, and after pregnancy

Hyperprolactinemia should actively be investigated as a potential reason of infertility. Underlying prolactinomas may successfully be treated with dopamine agonists. However, patients with micro- or well-circumscribed macroprolactinomas (Knosp 0 or 1) should also be informed about transsphenoidal surgery offering cure in contrast to long-lasting medical therapy. Management prior to and during pregnancy is usually unremarkable but may pose some specific challenges.

Automated summary

Hyperprolactinemia should be actively investigated as a potential cause of infertility. Dopamine agonists can successfully treat underlying prolactinomas. However, patients with micro- or well-circumscribed macroprolactinomas (Knosp 0 or 1) should also be informed about the possibility of cure through transsphenoidal surgery instead of long-term medical therapy. Management during pregnancy is usually uncomplicated but may present some specific challenges.