To treat or not to treat: hyperprolactinemia

Abstract

ABSTRACT Physicians are overtreating hyperprolactinemia, says Michele C. S. Koppelman, MD, of the National Institute of Child Health and Development (NICHD), Bethesda, Md.At the recent meeting of the Endocrine Society in San Francisco, Koppelman reported on a follow-up study of 25 female patients with long-standing, untreated hyperprolactinemia. Most of the patients' conditions remained stable or improved clinically over the years, and some showed apparent regression of pituitary adenomas.On average, the onset of the patients' symptoms predated the follow-up study by 11.3 years and the diagnoses of hyperprolactinemia by 5.3 years. Half of the women had had initial serum prolactin levels higher than 200 ng/mL, and two thirds had had levels exceeding 100 ng/mL. In 15 patients, skull x-ray films and polytomography of the pituitary fossa had shown abnormalities in the sella turcica. None of the patients with these abnormalities had visual field defects, but several had headaches.At the