Treatment of galactorrhea-amenorrhea.

A patient complaining of abnormal lactation and amenorrhea should be evaluated for a pituitary tumor. The work-up includes a thorough history and physical examination, serum prolactin and thyroid-stimulating hormone (TSH) determinations, and radiographic assessment of the pituitary gland. The treatment of choice for hyperprolactinemia leading to abnormal lactation is bromocriptine mesylate, even when small pituitary tumors are present. Surgery is reserved for patients who fail to respond to medical treatment and have tumors larger than 1 cm.