Prolactin and reproductive medicine

Purpose of review This review aims to summarize current knowledge about prolactin, and outlines recent information that affects the management of patients with hyperprolactinaemia. Recent findings The actions of prolactin have been clarified by studies of prolactin-receptor-deficient mice, which have a clear phenotype of reproductive failure at multiple sites. The treatment of patients with hyperprolactinaemia or prolactinoma is largely achieved using dopamine agonist drugs, which induce the shrinkage of pituitary prolactinomas as well as control of the endocrine syndrome. Recent findings indicate that successful cabergoline treatment may be able to induce long-term remission, allowing drug withdrawal in a substantial proportion of patients. Summary At present, dopamine agonist drugs remain the best treatment for hyperprolactinaemic patients, and can help most affected women achieve pregnancy. Future work is likely to help understand the basis of long-term remission in patients with pituitary prolactinomas.