Patient's question:
Pituitary microadenoma, high testosterone and prolactinDoctor's answer:
Treatment of Microadenomas. It is recommended to use bromocriptine therapy, starting with a low dose and taken orally during meals or before bedtime to reduce side effects such as nausea, vomiting, weakness, nasal congestion, and orthostatic hypotension. The dose should be gradually increased, and the medication should be continued for 2 to 6 months. In patients, galactorrhea disappears, menstruation returns to normal, blood PRL levels drop to normal, the adenoma shrinks, and fertility is restored. If the patient is confirmed to be pregnant, bromocriptine can be discontinued immediately, but clinical symptoms and visual fields should be monitored regularly to observe whether pregnancy causes the adenoma to grow. It is now believed that bromocriptine has no teratogenic effects. Generally, medication should be continued after delivery, but in 1/6 of patients with pituitary PRL microadenomas, blood PRL levels remain normal after bromocriptine is discontinued. There are also reports in the literature of using other D2 receptor agonists, such as sphenicride and ergot ethyl, to treat pituitary PRL tumors.