Table of Contents

INTRODUCTION

PROLACTIN SECRETION

CAUSES OF HYPERPROLACTINEMIA

Hypothalamic Dopamine Deficiency

Defective Transport Mechanisms

Lactotroph Insensitivity to Dopamine

Stimulation of Lactotrophs

CLINICAL MANIFESTATIONS OF HYPERPROLACTINEMIA

DIFFERENTIAL DIAGNOSIS

CHANGES IN THE BREAST DUE TO PROLACTIN

IMAGING OF THE PITUITARY (See Also Chapter 4)

TREATMENT OF HYPERPROLACTINEMIA

Dopamine Agonist Drug Therapy

Effects of Dopamine Agonist Drugs in Hyperprolactinemic Men

Dopamine Agonist Drugs in Amenorrhea

Long-Term Effects of Bromocriptine

Hyperprolactinemia and Ovulation

Hyperprolactinemic Hypogonadism

Suppression of Gonadal Function in Hyperprolactinemia

Reduction in Size of Prolactinomas

Changes in Pituitary Volume During Bromocriptine Therapy

Changes in Serum Prolactin Levels

Side Effects

Pregnancy and Bromocriptine

CONCLUSION