Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul;89(1):212-221.
doi: 10.1007/s12020-025-04215-w. Epub 2025 Apr 9.

Response to cabergoline treatment, gonadal axis recovery, and outcomes of drug withdrawal, in men with microprolactinoma: a retrospective cohort study

Yaron Rudman  1   2 , Neta Simon  2 , Rona Shimon  3 , Genady Drozdinsky  2   4 , Efrat Markus  2   5 , Hadar Duskin-Bitan  1   2 , Hiba Masri-Iraqi  1   2 , Gloria Tsvetov  1   2 , Amit Akirov  1   2 , Ilan Shimon  6   7
Affiliations

Response to cabergoline treatment, gonadal axis recovery, and outcomes of drug withdrawal, in men with microprolactinoma: a retrospective cohort study

Yaron Rudman et al. Endocrine. 2025 Jul.

Abstract

Purpose: Due to the low incidence of male microprolactinoma, there is a paucity of data in the literature regarding its management. Our aim was to investigate the long-term outcomes of cabergoline treatment in men with microprolactinoma.

Methods: In this single-center retrospective cohort study, we reviewed patient's records at prolactinoma diagnosis, following cabergoline discontinuation (if occurred), and at the last clinic visit. We collected all available clinical data, laboratory tests, and pituitary magnetic resonance imaging. We report response rates, gonadal axis recovery, and outcomes following cabergoline discontinuation.

Results: The study cohort included 47 men with microprolactinoma [age at diagnosis 45.6 ± 17.6 years; median prolactin 70.0 ng/ml (IQR 51.0-103.4); low testosterone, 34 men (72.3%); adenoma diameter 5.6 ± 2.0 mm; median follow-up 7.1 years (IQR 3.5-10.4)]. Forty-two patients (89.4%) achieved normal prolactin levels within a median treatment time of 4.0 months (IQR 3.0-5.5) and had normal testosterone at last clinic visit. Five men (10.6%) did not achieve prolactin normalization, of whom 3 men remained hypogonadal. Mild side effects occurred in 4.3% of patients and disappeared with dose reduction. Thirteen men that achieved normal prolactin attempted drug discontinuation, but only 5 remained with normoprolactinemia. Men who maintained normal prolactin levels were treated longer with cabergoline [median treatment of 10 years (IQR 4.6-10.3) vs 2.0 years (IQR 1.5-3.2); p < 0.01].

Conclusions: Ninety percent of men harboring microprolactinoma achieved normoprolactinemia and subsequent testosterone normalization with cabergoline treatment. Men that discontinued cabergoline after prolonged prolactin suppression (>5 years) achieved sustained remission. These findings assist informed decision-making, between medical and surgical treatment.

Keywords: Cabergoline; Men; Pituitary microadenoma; Prolactin; Prolactinoma.

PubMed Disclaimer

Conflict of interest statement

Compliance with ethical standards. Conflict of interest: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patient selection flowchart
Fig. 2
Fig. 2
Box plot diagrams showing (a) prolactin, (b) testosterone, and (c) hemoglobin levels at the time of prolactinoma diagnosis and at the end of follow-up (following cabergoline treatment), in 42 men with microprolactinoma who achieved normal prolactin levels (responders) compared with 5 men with microprolactinoma who did not achieve normal prolactin levels (non-responders)
Fig. 3
Fig. 3
Box plot diagrams showing (a) prolactin and (b) testosterone levels at the time of prolactinoma diagnosis, before cabergoline discontinuation, and after cabergoline discontinuation, in 5 men with microprolactinoma without hyperprolactinemia recurrence, and in 8 men with recurrent hyperprolactinemia after treatment discontinuation
See this image and copyright information in PMC

References

    1. A Fernandez, N Karavitaki, JA Wass, Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin. endocrinol. (Oxf.). 72(3), 377–382 (2010). 10.1111/j.1365-2265.2009.03667.x. - PubMed
    1. T Mindermann, CB Wilson, Age-related and gender-related occurrence of pituitary adenomas. Clin. Endocrinol. (Oxf.). 41(3), 359–364 (1994). 10.1111/j.1365-2265.1994.tb02557.x. - PubMed
    1. P Chanson, D Maiter, The epidemiology, diagnosis and treatment of Prolactinomas: The old and the new. Best. Pract. Res. Clin. Endocrinol. Metab. 33(2), 101290 (2019). 10.1016/j.beem.2019.101290. - PubMed
    1. JJ Pinzone, L Katznelson, DC Danila, DK Pauler, CS Miller, A Klibanski, Primary medical therapy of micro- and macroprolactinomas in men. J. clin. Endocrinol. Metab. 85(9), 3053–3057 (2000). 10.1210/jcem.85.9.6798. - PubMed
    1. A Colao, G Vitale, P Cappabianca, F Briganti, A Ciccarelli, MDe Rosa, S Zarrilli, G Lombardi, Outcome of cabergoline treatment in men with prolactinoma: effects of a 24-month treatment on prolactin levels, tumor mass, recovery of pituitary function, and semen analysis. J. clin. Endocrinol. Metab. 89(4), 1704–1711 (2004). 10.1210/jc.2003-030979. - PubMed

LinkOut - more resources