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Indications for hyperprolactinemia therapy.

Before initiating treatment for hyperprolactinemia, it is necessary to verify the diagnosis. It is also essential to remember that hyperprolactinemia is in itself simply an abnormal "lab value" that reflects the presence of an underlying pathophysiologic cause. All possible causes must be considered and either identified or ruled out before therapy is initiated. The vast majority of people with hyperprolactinemia can be treated medically with dopamine agonist medications. The indications for treatment include: (1) the presence of significant symptoms, such as infertility, ovulatory dysfunction or galactorrhea in women and infertility or gynecomastia in men; (2) the presence of significant signs, such as visual field defects or cranial nerve palsies; and (3) abnormal test results, including visualization of a pituitary mass or lesion or detection of osteopenia.