Alternative Dopamine Agonists
In cases where patients do not respond well to the commonly prescribed dopamine agonist, there is an alternative option available. This alternative is generally better tolerated by most patients and has shown to be more effective in restoring ovulation in women with lower prolactin levels. Interestingly, around 70 percent of patients who did not see positive results with the initial treatment have shown a positive response to this second option. However, the downside is that the alternative medication is considerably more expensive due to its increased effectiveness, fewer side effects, and newer nature. As a result, this higher cost can pose a significant obstacle for many patients who may struggle to afford the medication.
Transsphenoidal Surgery: A Preferred Option for Treating Prolactinoma
When it comes to treating prolactinoma, physicians may opt for surgery instead of prescribing dopamine agonist medications for a variety of reasons. Typically, surgery is considered for patients who are unable to tolerate medications or when the medications prove ineffective in shrinking the tumor. The transsphenoidal pituitary adenomectomy is considered the safest surgical procedure for prolactinoma. During this procedure, the surgeon aims to remove the adenoma by accessing it through the nasal cavity. Since the surgeon does not come into direct contact with other areas of the brain, the risk of complications associated with this surgery remains relatively low. Furthermore, one notable advantage of transsphenoidal surgery is that it does not result in any visible scarring.