Juraj Hrnčiar
Prolactine is a hypophysis proteohormone controlling secretion of milk and inhibiting FSH and LH output as well as secretion of gonade hormones. Hyperprolaktinaemia can be triggered not only by prolactinomes but also by other diseases and various drugs. Prolactinomes are frequently benign tumours of the hypophysis. Hyperprolactonaemia in women in fertile age results in secondary amenorrhea and galactorrhea. Signs are less apparent in children, post-climacteric women and men. It is hypogonadism, sterility, sexual disorders and low bone density. Prolactinomes of the hypophysis are diagnosed later in these cases and they are usually bigger. A long term pharmacotherapy with dopaminergic agonists (bromokryptine, cabergoline etc.) dominates in therapy of prolactinomes and hyperprolactinaemia is settled and substantial regression, even disappearance of volume of prolactinomes happens. Menorrhea and fertility is renewed, and consequences of induced hypogonadism disappear. Standardized medicament therapy monitoring by levels of prolactine and tumor size by NMR is the first and very successful therapeutic method not only for microprolactinomes (tumours up to 10 mm, 90 %), but also for maroprolactinomes (tumours over 10 mm). Only for pharmacologically resistant macrotumours threatening chiazma opticum by pressure, neurosurgical intervention is considered that might not solve the problem for ever and consequently a risk radiotherapy is inevitable.