Usually, your doctor will stop treatment once you are pregnant. Cabergoline is taken twice a week and has fewer side effects than bromocriptine. Generally, cabergoline drops prolactin levels to normal faster than bromocriptine does. Cabergoline can cause heart valve problems when taken in high doses, but these doses are not used in women who are trying to get pregnant. Bromocriptine and cabergoline can been used when woman is pregnant. The most common side effects are lightheadedness, nausea, and headache.
Slowly increasing the dose helps with side effects. Another way to decrease the side effects is to give bromocriptine in a suppository directly in the vagina. This is an off-label use of the medicine. Not all women with hyperprolactinemia need treatment, although women with hyperprolactinemia who do not make estrogen as a result need a treatment that either causes her to make estrogen or provides estrogen to the patient. Women with hyperprolactinemia can still take birth control pills to keep from getting pregnant or make their periods regular.
Although doctors most often treat prolactinomas with medicines, in some cases surgery may be an option. Examples include. In some cases, when a prolactinoma is large, a woman may choose to have surgery to remove the tumor before trying to become pregnant. When done by an experienced surgeon, the surgery corrects prolactin levels in about 90 percent of people with small tumors and 50 percent of those with large tumors.
More rarely, if medicines and surgery fail to reduce prolactin levels, radiation therapy may be used. This type of treatment uses high-energy x-rays or particle waves to kill tumor cells. Depending on the size and location of the tumor, the total radiation dose is delivered in one session, or in lower doses over the course of 4 to 6 weeks.
Prolactin levels return to normal in 1 out of 3 patients treated with radiation therapy. Your doctor is likely to prescribe medicines while you wait to see results.
Side effects and complications. The most common side effect is low levels of thyroid hormone. In up to half of patients, radiation therapy may also lead to a decrease in other pituitary hormones.
Rarely, other types of tumors can develop many years later in areas that were in the path of the radiation beam. Before pregnancy. Having a prolactinoma may make it difficult for you to become pregnant, but treatment with dopamine agonists is very effective in restoring fertility. When pregnancy is confirmed.
Although studies suggest that both bromocriptine and cabergoline can be safely taken in the early stages of pregnancy, bromocriptine is typically preferred because of its longer safety record. During pregnancy. Prolactin levels normally increase during pregnancy, preparing your breasts to make milk after your baby is born. The pituitary gland often doubles in size during pregnancy. Your prolactinoma may also grow in size, especially if it is already large.
If you begin to have symptoms such as headaches and changes in vision, your doctor may recommend that you start taking the medicine again. After delivery. After delivery, women with small prolactinomas can usually nurse their babies.
Prolactin is a hormone made by the pituitary gland, a small gland at the base of the brain. Prolactin causes the breasts to grow and make milk during pregnancy and after birth. Prolactin levels are normally high for pregnant women and new mothers. Levels are normally low for nonpregnant women and for men. If prolactin levels are higher than normal, it often means there is a type of tumor of the pituitary gland, known as a prolactinoma. This tumor makes the gland produce too much prolactin.
Excess prolactin can cause the production of breast milk in men and in women who are not pregnant or breastfeeding. In women, too much prolactin can also cause menstrual problems and infertility the inability to get pregnant. In men, it can lead to lower sex drive and erectile dysfunction ED. Also known as impotence, ED is the inability to get or maintain an erection. Prolactinomas are usually benign noncancerous. But left untreated, these tumors can damage surrounding tissues.
Other symptoms are different depending on whether you are a man or woman. If you are a woman, symptoms also depend on whether you have gone through menopause. Menopause is the time in a woman's life when her menstrual periods have stopped and she can't become pregnant anymore. It usually starts when a woman is around 50 years old. Women who have gone through menopause may not have symptoms until the condition worsens. Excess prolactin after menopause often causes hypothyroidism.
Prolactinoma might not cause any noticeable signs or symptoms. However, excessive prolactin in your blood hyperprolactinemia or pressure on surrounding tissues from a large tumor can cause signs or symptoms. Because elevated prolactin can disrupt the reproductive system hypogonadism , some of the signs and symptoms of prolactinoma are specific to females or males. Women tend to notice signs and symptoms earlier than men do, when tumors are smaller in size, probably because of missed or irregular menstrual periods.
Men tend to notice signs and symptoms later, when tumors are larger and more likely to cause headache or vision problems. If you develop signs and symptoms associated with prolactinoma, see your doctor to determine the cause. The pituitary gland and the hypothalamus are located within the brain and control hormone production. The endocrine system includes the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas, ovaries in females and testicles in males.
Prolactinoma is one type of tumor that develops in the pituitary gland. The cause of these tumors is unknown. The pituitary gland is a small bean-shaped gland situated at the base of your brain. Despite its small size, the pituitary gland influences nearly every part of your body.
Its hormones help regulate important functions such as growth, metabolism, blood pressure and reproduction. Other possible causes of prolactin overproduction include medications, other types of pituitary tumors, an underactive thyroid gland, ongoing irritation to the chest, pregnancy and breast-feeding.
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