Two-year treatment with oral contraceptives in hyperprolactinemic patients

Testa, Giovanna; Vegetti, Walter; Motta, Tiziano; Alagna, Federica; Bianchedi, D.; Carlucci, Clelia; Bianchi, M; Parazzini, Fabio; Crosignani, Pier Giorgio

doi:10.1016/s0010-7824(98)00069-9

Cited by 62 publications

(24 citation statements)

References 15 publications

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“…In addition, this study did not show any significant difference between male and female subjects in their response to DAs, nor between females taking or not taking estrogen contraceptives. This is in accord with the report showing no adverse effects of oral contraceptive therapy on PRL levels (which fell non-significantly) or radiological findings in 16 women during a 2-year follow-up period [24].…”

Section: Discussionsupporting

confidence: 92%

Effect of dopamine agonists on prolactinomas and normal pituitary assessed by dynamic contrast enhanced magnetic resonance imaging (DCE-MRI)

et al. 2007

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Section: Discussionsupporting

confidence: 92%

Effect of dopamine agonists on prolactinomas and normal pituitary assessed by dynamic contrast enhanced magnetic resonance imaging (DCE-MRI)

et al. 2007

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“…On the other hand most studies have shown either no [42][43][44][45] or minimal effect [46] on PRL levels of estrogen replacement therapy following oophorectomy or at menopause with varying doses of estrogens up to 1.25 mg of conjugated estrogens or 50 µg of estradiol daily. Estrogens given to women with prolactinomas generally do not cause prolactinomas to grow [47,48], although individual case reports of such growth have been reported [49][50][51]. However, specific information regarding an alteration in sensitivity to dopamine agonists with estrogen use has not been reported.…”

Section: Late Development Of Dopamine Agonist Resistancementioning

confidence: 99%

“…Of course, for patients with microadenomas who do not desire fertility, simply treating with estrogen replacement without even attempting dopamine agonist therapy is often all that is necessary [47,48]. There generally is no increase in tumor size with such estrogen replacement [47,48] but PRL levels must be monitored to detect the rare patient who may be estrogen sensitive.…”

Section: Treatment Approaches For Patients Resistant To Dopamine Agonmentioning

confidence: 99%

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Pharmacologic Resistance in Prolactinoma Patients

2005

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Pharmacologic resistance to dopamine agonists is defined here as failure to normalize PRL levels and failure to decrease macroprolactinoma size by >or=50%. Failure to normalize PRL levels is found in about one-quarter of patients treated with bromocriptine and 10-15% of those treated with pergolide or cabergoline. Failure to achieve at least a 50% reduction in tumor size occurs in about one-third of those treated with bromocriptine and 10-15% of those treated with pergolide or cabergoline. The cause of dopamine resistance is primarily a decrease in D(2) receptors but the receptors have normal affinity for dopamine. Treatment approaches for patients resistant to dopamine agonists include changing to another dopamine agonist and increasing the dose of the drug as long as there is continued response to the dose increases and no adverse effects with higher doses. Transsphenoidal surgery is also an option. Clomiphene, gonadotropins, and GnRH can be used if fertility is desired. For those not desiring fertility, estrogen replacement may be used unless there is a macroadenoma, in which case control of tumor growth is also an issue and dopamine agonists are generally necessary. In many patients modest or even no reduction in tumor size may be acceptable as long as there is not tumor growth. Hormone replacement (estrogen or testosterone) may cause a decrease in efficacy of the dopamine agonist so that it must be carried out cautiously. Reduction of endogenous estrogen, use of selective estrogen receptor modulators, and aromatase inhibitors are potential experimental approaches.

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“…Тестостерон вызывает увеличе-ние секреции ПРЛ, но в значительно меньшей сте-пени, чем эстрогены. Тиреоидные гормоны, глюко-кортикоиды и дексаметазон снижают реакцию ПРЛ на тиреолиберин на уровне гипофиза [12][13][14].…”

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The influence of balneo- and peloid therapy on the characteristics of the hormonal regulation in the women presenting with bacterial vaginosis

2015

Vopr. kurortol. fizioter. lech. fiz. kul't.

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Two-year treatment with oral contraceptives in hyperprolactinemic patients

Cited by 62 publications

References 15 publications

Effect of dopamine agonists on prolactinomas and normal pituitary assessed by dynamic contrast enhanced magnetic resonance imaging (DCE-MRI)

Effect of dopamine agonists on prolactinomas and normal pituitary assessed by dynamic contrast enhanced magnetic resonance imaging (DCE-MRI)

Pharmacologic Resistance in Prolactinoma Patients

The influence of balneo- and peloid therapy on the characteristics of the hormonal regulation in the women presenting with bacterial vaginosis

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