Hyperprolactinemia syndrome in the outpatient practice of an obstetrician-gynecologist (Clinical lecture)

Pyrohova, V.I.; Shurpyak, S.O.

doi:10.15574/hw.2017.125.10

Cited by 2 publications

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“…Long-term clinical practice has shown that cabergoline normalizes the level of PRL in the blood in 86-92% of cases, leads to regression of pituitary microadenomas in 16-74%, macroadenomas -in 44-91%, helps to restore ovulation in women in 67-89% of cases. However, the average frequency of adverse events with the use of cabergoline in different studies ranged from 13 to 70%, depending on the therapeutic dose [9]. At the same time, it should be emphasized that in the DAs treatment many problems arise, the solution of which does not have an unambiguous answer.…”

Section: Resultsmentioning

confidence: 99%

Current and Perspective Approaches to the Treatment of Prolactinomas

Barabash,

Tykhonova,

Kanishcheva

2023

AML

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Background: Along with the presence of the 2011 Endocrine Society Clinical Practice Guidelines and numerous large-scale studies on the treatment of hyperprolactinemia of different origin, there are some unresolved questions, ambiguous and sometimes contradictory points of view regarding the management of patients with prolactinomas. This overview is devoted to the analysis of the results of modern clinical studies and the approaches towards the management of hyperprolactinemia caused by prolactinoma.Materials and methods: A systematic research of the literature for the appropriate keywords published mainly for the last 10 years was done; also, a reference list of each selected article was analysed. We included to our review the articles reporting controversial issues or new data on the treatment of hyperprolactinemia.Results: The review describes various problems arising during the treatment of prolactinoma. The presence of primary and secondary dopamine agonist resistance in each case requires an individual approach, and sometimes may include the use of the antineoplastic agent temozolomide. The side effects of dopamine agonists are discussed, with quite rare ones, including valvulopathy, pathological psychological conditions and cerebrospinal rhinorrhea. The controversial issue of the duration and doses of the drug used to achieve a lasting effect in the treatment of prolactinomas is considered. There are some points connected with the frequency of relapses. Thus, recurrence is correlated to the duration of treatment with dopamine agonists, prolactin levels at diagnosis, and the initial tumor size. Metformin, somatostatin analogues, selective estrogen receptor modulators, tyrosine kinase inhibitors, inhibitors of the mammalian target of rapamycin, epidermal growth factor receptor antagonists are investigated nowadays as potential alternative methods of drug treatment of prolactinomas. Conclusion: Drug therapy with dopamine agonists makes it possible to achieve the desired results in the vast majority of patients. However, despite the proven safety of this group of medicines, the risk of side effects should still be taken into account. The therapy regimen should be determined by the clinical course of prolactinoma and the patient’s response to treatment. Other options of treatment should be considered in patients intolerant to medical therapy, with contraindication or resistance to dopamine agonists, in the case of a malignant tumor. The presence of refractory to any of the applied methods of treatment and aggressive prolactinomas leads to the search for new drugs.

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Section: Resultsmentioning

confidence: 99%

Current and Perspective Approaches to the Treatment of Prolactinomas

Barabash,

Tykhonova,

Kanishcheva

2023

AML

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Hyperprolactinemic Hipogonadism: Prediction of Effectiveness Treatment and Management

Yermolenko,

Rozhkovska,

Andriyivskyy

2022

OMŽ

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Hyperprolactinemia syndrome (HPRL) is one of the most common neuroendocrine diseases, leading to the development of hypogonadism in young women. The aim of the study was to study the effectiveness of treatment of menstrual and reproductive disorders caused by hyperprolactinemia, depending on the nature of the relationship of gonadotropic hormones. Materials and methods. 98 women of reproductive age were monitored, of which 78 — with functional HPRL and 20 healthy women. Clinical-anamnestic, enzyme-linked immunosorbent, instrumental (perimetry, computed tomography), functional, statistical research methods were used. The effectiveness of therapy for menstrual and reproductive disorders caused by HPRL, depending on the nature of the relationship of gonadotropic hormones (GH). Results. In patients of reproductive age with HPRL there are four types of GH secretion: the first — LH and FSH levels are reduced; the second — the level of LH is increased and FSH is reduced; third — the level of LH is reduced and FSH is increased; the fourth type — LH and FSH levels are both elevated. As a result of the treatment, ovarian function was restored in the first type of GH secretion in 83.6% of patients, in the second type — in 66.7% of patients, in the third — in 37.5%. In the group of women with HPRL and high levels of GH normalization of the menstrual cycle and restoration of reproductive function did not occur. Conclusions. Detection of four types of GH secretion in HPRL indicates the presence of different pathogenetic features of this pathology, which must be taken into account when prescribing personalized therapy to restore ovarian function and fertility, timely use of assisted reproductive technologies. Key words: hyperprolactinemia, hypogonadism, pathogenetic features, prognosis, therapy.

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Hyperprolactinemia syndrome in the outpatient practice of an obstetrician-gynecologist (Clinical lecture)

Cited by 2 publications

References 0 publications

Current and Perspective Approaches to the Treatment of Prolactinomas

Current and Perspective Approaches to the Treatment of Prolactinomas

Hyperprolactinemic Hipogonadism: Prediction of Effectiveness Treatment and Management

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