Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement

Stephan Petersenn*, Maria Fleseriu, Felipe F. Casanueva, Andrea Giustina, Nienke Biermasz, Beverly M.K. Biller, Marcello Bronstein, Philippe Chanson, Hidenori Fukuoka, Monica Gadelha, Yona Greenman, Mark Gurnell, Ken K.Y. Ho, Jürgen Honegger, Adriana G. Ioachimescu, Ursula B. Kaiser, Niki Karavitaki, Laurence Katznelson, Maya Lodish, Dominique MaiterHani J. Marcus, Ann McCormack, Mark Molitch, Christopher A. Muir, Sebastian Neggers, Alberto M. Pereira, Rosario Pivonello, Kalmon Post, Gerald Raverot, Roberto Salvatori, Susan L. Samson, Ilan Shimon, Joanna Spencer-Segal, Greisa Vila, John Wass, Shlomo Melmed

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


This Consensus Statement from an international, multidisciplinary workshop sponsored by the Pituitary Society offers evidence-based graded consensus recommendations and key summary points for clinical practice on the diagnosis and management of prolactinomas. Epidemiology and pathogenesis, clinical presentation of disordered pituitary hormone secretion, assessment of hyperprolactinaemia and biochemical evaluation, optimal use of imaging strategies and disease-related complications are addressed. In-depth discussions present the latest evidence on treatment of prolactinoma, including efficacy, adverse effects and options for withdrawal of dopamine agonist therapy, as well as indications for surgery, preoperative medical therapy and radiation therapy. Management of prolactinoma in special situations is discussed, including cystic lesions, mixed growth hormone-secreting and prolactin-secreting adenomas and giant and aggressive prolactinomas. Furthermore, considerations for pregnancy and fertility are outlined, as well as management of prolactinomas in children and adolescents, patients with an underlying psychiatric disorder, postmenopausal women, transgender individuals and patients with chronic kidney disease. The workshop concluded that, although treatment resistance is rare, there is a need for additional therapeutic options to address clinical challenges in treating these patients and a need to facilitate international registries to enable risk stratification and optimization of therapeutic strategies.

Original languageEnglish
Pages (from-to)722-740
Number of pages19
JournalNature Reviews Endocrinology
Issue number12
StatePublished - Dec 2023


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