if a woman has a small prolactinoma there is usually no reason that she cannot conceive and have a normal pregnancy after successful medical therapy. the pituitary enlarges and prolactin production increases during normal pregnancy in women without pituitary disorders. women with prolactin-secreting tumors may experience further pituitary enlargement and must be closely monitored during pregnancy. but damage to the pituitary or eye nerves occurs in less than 1% of pregnant women with prolactinomas. in women with large tumors the risk of damage to the pituitary or eye nerves is greater. if a woman has already completed a successful pregnancy the likelihood of future successful pregnancies is extremely high. a woman with a prolactinoma should discuss her plans to conceive with her physician so she can be carefully evaluated prior to pregnancy. this evaluation typically includes a magnetic resonance imaging (mri) scan to assess the size of the tumor and an eye examination with measurement of visual fields. as soon as the patient becomes pregnant her doctor will usually advise that she discontinue bromocriptine (parlodel) or cabergoline (dostinex). patients should consult their hormone specialists (endocrinologists) promptly if symptoms develop – particularly headaches visual changes nausea vomiting excessive thirst or urination or extreme lethargy. bromocriptine or cabergoline treatment may be renewed and additional treatment may be required if symptoms occur as a result of growth of the tumor during pregnancy.
does a prolactinoma affect pregnancy?