- Author: Donald Shenenberger, MD, FAAD, FAAFP; Chief Editor: George T Griffing, MD more...
Further Outpatient Care
Once the diagnosis has been established and therapy initiated, fasting prolactin levels should be monitored monthly. Later, prolactin levels can be monitored every 3-6 months. Shrinkage of the tumor should be followed by formal visual-field testing and MRI.
Potential complications of hyperprolactinemia are primarily related to tumor size and the physiologic effects of the condition. These include blindness, hemorrhage, osteoporosis, and infertility.
When monitored for longer than 7 years, 90-95% of microadenomas remained stable or gradually decreased prolactin secretion.
One third of patients with idiopathic hyperprolactinemia may experience resolution without treatment. This number increases to two thirds if the patient's basal prolactin level is less than 40 ng/mL.
Surgery is often not curative for macroprolactinomas, with a recurrence rate of as high as 40% within 5 years.
Recurrence rates of hyperprolactinemia are as high as 80%, and, subsequently, patients require long-term medical therapy.
A decrease in prolactin levels may restore ovulation. Advice about birth control methods should be given when prolactin levels approach the normal range.
For excellent patient education resources, visit eMedicineHealth's Women's Health Center. Also, see eMedicineHealth's patient education article Amenorrhea.
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