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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For A Cyst On The Pituitary Gland

Hi,

Last year i find out that I have a high prolactin level from my blood work which is 35. So I have MRI done and they find 2mm cyst on pituitary gland. they suggested i see neurology for follow up. The reason why im worry is because , my breast hurts so bad every month but my period have been very regular for the pass 8 months. So now should i worry about it and see neurology?will this cause infertility since we are just starting trying to conceive.
Wed, 9 Nov 2016
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General & Family Physician 's  Response
Dear Madam, Hi & Welcome.

Based on the history and the lab tests done you seem to be suffering from hyperprolactinemia (increased prolactin level in the blood) due to small tumor (microadenoma) in the anterior pituitary gland.

Hyperprolactinemia can cause infertility due to amenorrhea or irregular menses, breast engorgement and galactorrhea (increased milk secretion).

You need to consult a gynecologist who is specialized in fertility treatment.
You may be given treatment in the form of dopamine agonists like Bromocriptine or Cabergoline which are effective in decreasing the prolactin levels and they may also shrink the tumor.

Cabergoline is usually preferred over since it is more effective and causes fewer adverse effects than Bromocriptine.

The response to therapy should be monitored by checking fasting serum Prolactin levels and checking tumor size with MRI. Most women (approximately 90%) regain cyclic menstruation and achieve resolution of galactorrhea.

Therapy should be continued for approximately 12-24 months (depending on the degree of symptoms or tumor size) and then withdrawn if prolactin levels have returned to the normal range & no adenoma (cyst) is seen on magnetic resonance imaging (MRI).

If drug therapy for prolactinoma doesn't work or you can't tolerate the medication, surgery to remove the tumor may be an option.

Hope the advice given above would be useful.
Best wishes.
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Suggest Treatment For A Cyst On The Pituitary Gland

Dear Madam, Hi & Welcome. Based on the history and the lab tests done you seem to be suffering from hyperprolactinemia (increased prolactin level in the blood) due to small tumor (microadenoma) in the anterior pituitary gland. Hyperprolactinemia can cause infertility due to amenorrhea or irregular menses, breast engorgement and galactorrhea (increased milk secretion). You need to consult a gynecologist who is specialized in fertility treatment. You may be given treatment in the form of dopamine agonists like Bromocriptine or Cabergoline which are effective in decreasing the prolactin levels and they may also shrink the tumor. Cabergoline is usually preferred over since it is more effective and causes fewer adverse effects than Bromocriptine. The response to therapy should be monitored by checking fasting serum Prolactin levels and checking tumor size with MRI. Most women (approximately 90%) regain cyclic menstruation and achieve resolution of galactorrhea. Therapy should be continued for approximately 12-24 months (depending on the degree of symptoms or tumor size) and then withdrawn if prolactin levels have returned to the normal range & no adenoma (cyst) is seen on magnetic resonance imaging (MRI). If drug therapy for prolactinoma doesn t work or you can t tolerate the medication, surgery to remove the tumor may be an option. Hope the advice given above would be useful. Best wishes.