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Hyperprolactinemia after menopause: Diagnosis and management.

Renata S Auriemma1, Rosa Pirchio1, Rosario Pivonello2

  • 1Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.

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|August 27, 2021
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Summary

Diagnosing prolactinomas in postmenopausal women presents unique challenges due to the absence of typical symptoms. Management requires careful consideration of dopamine agonist therapy withdrawal, especially for macroprolactinomas.

Keywords:
BoneDopamine agonistsHyperprolactinemiaMenopauseMetabolic impairmentPituitary tumorProlactin

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Area of Science:

  • Endocrinology
  • Reproductive Medicine

Background:

  • Prolactinomas are common in reproductive-age women, typically presenting as microadenomas.
  • Diagnosis in postmenopausal women is less frequent and often lacks classic hyperprolactinemia symptoms like infertility.

Purpose of the Study:

  • To review the diagnostic challenges and therapeutic management of prolactinomas in postmenopausal women.
  • To discuss the implications of menopause on prolactinoma management and dopamine agonist therapy.

Main Methods:

  • Literature review focusing on prolactinomas in postmenopausal women.
  • Analysis of diagnostic criteria and treatment strategies.

Main Results:

  • Delayed diagnosis is common in postmenopausal women due to atypical presentations.
  • Dopamine agonist therapy withdrawal may be feasible for microprolactinomas but requires caution for macroprolactinomas.

Conclusions:

  • Management of prolactinomas in postmenopausal women necessitates a tailored approach, considering hormonal changes and tumor size.
  • Further research is needed to establish optimal long-term management strategies for this population.