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Multicenter Study
. 2016 Feb;60(1):42-6.
doi: 10.1590/2359-3997000000138.

Prolactinomas: evolution after menopause

Maria Susana Mallea-Gil  1 , Marcos Manavela  1 , Analia Alfieri  1 , Maria Carolina Ballarino  1 , Alberto Chervin  1 , Karina Danilowicz  1 , Sabrina Diez  1 , Patricia Fainstein Day  1 , Natalia García-Basavilbaso  1 , Mariela Glerean  1 , Mirtha Guitelman  1 , Débora Katz  1 , Monica Graciela Loto  1 , Marcela Martinez  1 , Karina Miragaya  1 , Daniel Moncet  1 , Amelia Susana Rogozinski  1 , Marisa Servidio  1 , Graciela Stalldecker  1 , Marcelo Vitale  1 , Laura Boero  1
Affiliations
Multicenter Study

Prolactinomas: evolution after menopause

Maria Susana Mallea-Gil et al. Arch Endocrinol Metab. 2016 Feb.

Abstract

Objetive: The aim was to assess the evolution of tumor size and prolactin (PRL) levels in patients with micro and macroprolactinomas diagnosed and treated with dopamine agonists during fertile age, and the effects of suspension of drugs after menopause.

Subjects and methods: Retrospective study, 29 patients with prolactinomas, 22 microadenomas and 7 macroadenomas, diagnosed during their fertile age were studied in their menopause; treatment was stopped in this period. Age at menopause was 49 ± 3.6 years. The average time of treatment was 135 ± 79 months. The time of follow-up after treatment suspension was 4 to 192 months. Results: Pre-treatment PRL levels in micro and macroadenomas were 119 ± 57 ng/mL and 258 ± 225 ng/mL, respectively. During menopause after treatment suspension, and at the latest follow-up: in microadenomas PRL levels were 23 ± 13 ng/mL and 16 ± 5.7 ng/mL, respectively; in macroadenomas, PRL levels were 20 ± 6.6 ng/mL 5t5and 25 ± 18 ng/mL, respectively. In menopause after treatment suspension, the microadenomas had disappeared in 9/22 and had decreased in 13/22. In the group of patients whose tumor had decreased, in the latest follow-up, tumors disappeared in 7/13 and remained unchanged in 6/13. In macroadenomas, after treatment suspension 3/7 had disappeared, 3/7 decreased and 1/7 remained unchanged. In the latest control in the 3 patients whose tumor decreased, disappeared in 1/3, decreased in 1/3 and there was no change in the remaining.

Conclusions: Normal PRL levels and sustained reduction or disappearance of adenomas were achieved in most of patients, probably due to the decrease of estrogen levels. Dopamine agonists might be stopped after menopause in patients with prolactinomas.

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Conflict of interest statement

Disclosure: no potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1. Prolactin levels before treatment and after treatment suspension in patients with microprolactinomas (* p < 0.001).
Figure 2
Figure 2. (A) Percentage of menopausal patients with microprolactinomas, in whom tumor had disappeared or had decreased when treatment was stopped. (B) Percentage of patients with microprolactinomas whose tumors disappeared spontaneously or remained unchanged in the latest follow-up, from the group in which tumors had decreased in A.
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