Medical therapy of hyperprolactinemia.

Although many causes of hyperprolactinemia exist, medications and prolactin-secreting pituitary tumors (prolactinomas) are the most common etiologies. The mainstay of medical management for pituitary tumors as well as for most causes of hyperprolactinemia is bromocriptine. The drug can be used alone or in conjunction with other therapeutic modalities, including surgical resection and pituitary irradiation, depending on the clinical scenario. Bromocriptine can lower serum prolactin, reduce tumor size, and restore fertility in those patients during pregnancy. As bromocriptine is not always well tolerated and requires frequent dosing, newer agents that may diminish side effects and improve compliance are under investigation.