Hyperprolactinaemia: clinical presentation and dopamine agonist side effects

Frederik Klit; Sara Jensen; Anna-Sofie Barrett; Christian Rosendal; Amar Nikontovic; Jesper Karmisholt; Jakob Dal

doi:10.1530/endoabs.110.EP1123

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Endocrine Abstracts (2025) 110 EP1123 | DOI: 10.1530/endoabs.110.EP1123

ECEESPE2025 ePoster Presentations Pituitary, Neuroendocrinology and Puberty (220 abstracts)

Hyperprolactinaemia: clinical presentation and dopamine agonist side effects

Frederik Klit ^1,2 , Sara Jensen ² , Anna-Sofie Barrett ² , Christian Rosendal ^2,3 , Amar Nikontovic ¹ , Jesper Karmisholt ^2,3 & Jakob Dal ^2,3

Author affiliations

¹Aalborg University Hospital, Steno Diabetes Center North Denmark, Gistrup, Denmark; ²Aalborg University, Department of Clinical Medicine, Gistrup, Denmark; ³Aalborg University Hospital, Department of Endocrinology, Aalborg, Denmark

JOINT1183

Introduction: Pituitary diseases are diagnosed with increased frequency and with changes in the clinical presentation. Thus, we aimed to investigate the changes in clinical presentation of prolactin secreting pituitary neuroendocrine tumours (PRL-PitNET) and idiopathic hyperprolactinemia (IDH) including side effects of dopamine agonist (DA) treatment.

Methods: Patients with a PRL-PitNET or IDH were identified via ICD-coding in the period 2017-2022 in the North Denmark Region, Denmark. Data were collected from electronic patient records. Multiple imputation by chained equations were used for side effect association analyses.

Results: We identified 244 patients with a PRL-PitNET or IDH corresponding to a prevalence of 41.3 (95%CI: 39.2-43.5) per 100,000 pr year and an incidence rate of 2.8 [95%CI: 2.3-3.4] per 100,000 person years. Median age at diagnosis was 30 [IQI: 24;41] years. 77% were women. The prolactin level was 3.1 [IQI: 1.8;12.0] times upper reference limit. Median tumour diameter at diagnosis was 9 [IQI: 6;16] mm, and stabile over time. Macroadenomas constituted 46%. Women <53 years presented with menstrual disorders (90% *without hormonal contraceptives) and galactorrhoea (56%). Men presented with decreased libido (40%) and erectile dysfunction (34%), whereas galactorrhoea was uncommon (6% (n = 3)). 216 persons were or had been treated with DA. Normalisation of prolactin was achieved in 83% of patients on DA and <3% underwent surgery due to treatment resistance. However, 46% experienced concomitant side effects to DA. 19% (of 216) had specifically persistent side effects on DA and despite many attempted different DAs. 7% of all treated with DA underwent surgery or were followed without DA due to DA side effects. Side effects were not associated with age, sex, prolactin level or time to prolactin normalisation.

Conclusion: The prevalence of PRL-PitNET and IDH seem stabile. However, patients were younger and with lower prolactin levels despite a large proportion of macroadenomas. DA is effective. However, side effects were a more severe clinical problem than previously reported.