Hyperprolactinemia is a frequent finding in infertile women with amenorrhea. Bromocriptine is the drug of choice for treatment of hyperprolactinemic amenorrhea. This dopamine agonist is very effective in normalizing raised prolactin levels. Ovulatory menstrual cycles and fertility are then rapidly restored. Bromocriptine therapy represents a major advance in the treatment of anovulatory infertility. Prolactin-secreting pituitary adenomas are common causes of hyperprolactinemia. Neither surgery nor irradiation reliably provides the definitive cure that had been hoped for in patients with prolactin-secreting pituitary tumours. Experience with medical treatment has revealed that induction of ovulation with bromocriptine is remarkably safe both in patients with microtumours and those with macrotumours without suprasellar extension. In the future, it is possible that even the larger macrotumours with suprasellar can be safely managed by medical therapy with bromocriptine. During pregnancy, pituitary tumour complications may arise in women with prolactinomas. However, data accumulated during recent years have shown that induction of ovulation and pregnancy by bromocriptine is remarkably safe in women with both micro- and macroprolactinomas. The risk of permanent sequelae due to rapid tumour enlargement during pregnancy is exceedingly small in properly investigated and carefully supervised women with prolactinomas. Bromocriptine is clearly a must for every infertility clinic. The value of bromocriptine in the treatment of normoprolactinemic amenorrhea, polycystic ovarian disease, luteal insufficiency and ovulatory infertility is not yet proven. However, bromocriptine is extremely effective in normalizing hyperprolactinemia and undoubtedly the drug of choice for treatment of female infertility due to hypersecretion of prolactin.

Adenoma↗

PubMedDate not supplied

The long-acting dopamine agonist pergolide mesylate for treatment of hyperprolactinaemia.

Seven hyperprolactinaemic women were treated with the new, long-acting dopamine agonist pergolide mesylate. The treatment resulted in normalization of the prolactin secretion in four of the seven women and six of them experienced regular uterine bleedings. Four of the patients had previously discontinued bromocriptine because of adverse effects but had no problems to tolerate pergolide. One bromocriptine-resistant woman was unresponsive also to pergolide therapy. Reported side-effects in the seven women were mild and transient. Pergolide mesylate may be a valuable alternative to bromocriptine in the management of patients with hyperprolactinaemia.

Adult↗