Prolactinoma

MICROPROLACTINOMA

• For microprolactinomas, any clinically significant tumour growth is very rare during pregnancy and following use of low dose combined oral contraceptives.
• The presence of a microprolactinoma should therefore not be considered a contraindication to HRT.

MACROPROLACTINOMA

• Macroprolactinomas grow much more frequently following oestrogen exposure.
• They have been shown, for example, to have a 30-40% growth increase during pregnancy.
• There is no specific guidance on prescribing HRT to patients with macroprolactinoma and a cautious approach is recommended for these individuals, with advice sought from the patient’s neurology team.
• Each case should be taken on a case-by-case basis.
• If HRT is prescribed, close monitoring of the prolactinoma size and activity might be recommended.