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Prolactinoma - What about treatment during pregnancy?

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If the tumor is threatening your vision and you are trying to get pregnant, some doctors recommend treatment with bromocriptine. Cabergoline is also safe and over 90% of women can achieve a pregnancy with use of either drug. However, bromocriptine or cabergoline should be stopped as soon as you become pregnant. Only rare individuals with very large tumors will need to continue bromocriptine during pregnancy. Some endocrinologists recommend surgery prior to pregnancy when tumors are very large, as the normal pituitary and/or the tumor may grow, especially during late pregnancy.

Keep in mind that cabergoline will rapidly normalize prolactin levels and you could become pregnant even before your periods resume. You will need to use contraception if you do not desire a pregnancy immediately.

It is not necessary to routinely measure prolactin levels during pregnancy as it is normal for prolactin levels to rise as pregnancy progresses.

In women with microadenomas, it is not necessary to have an MRI scan or visual field examination during pregnancy as the risk of tumor enlargement is very small (less than 2%). In women with macroadenomas, it is advisable to monitor formal visual fields during each trimester.

Over 90% of women with prolactinomas can achieve a pregnancy while receiving treatment with dopamine agonists.