Prolactinoma. Who should avoid this?

Your MRI shows a small pituitary tumour (microadenoma), and your prolactin level is consistent with a prolactinoma. Cabergoline 0.25 mg twice a week is the correct first treatment and works well in most patients. Mild dizziness or nausea after the first few doses is common and usually settles. Taking it after dinner or at bedtime may help. Since pituitary tumours can occasionally produce more than one hormone, it is a good idea to check other hormones as well. These include morning cortisol, ACTH, TSH, Free T4, FSH, LH, IGF-1, HbA1c, fasting blood sugar (FBS), and post-meal blood sugar (PPBS) to check for insulin resistance You should also keep in mind the stalk effect, where a non-functioning pituitary tumour can mildly increase prolactin without actually producing it. In very large pituitary tumours, the hook effect can falsely show a lower prolactin level than the actual value, so repeating the test after serial dilution may be needed if the MRI and blood tests do not match.

Regular follow-up with an endocrinologist, repeat prolactin testing, and a follow-up MRI are important to monitor the response to treatment.

It can be treated with medications. Consult for further details

Your doctor's prescription is correct — Cabergoline is the first-line treatment for prolactinoma and highly effective. The mild dizziness you experienced is a very common initial side effect; taking the tablet at bedtime with food usually prevents it, and the dizziness typically fades within 1-2 weeks. High prolactin also worsens PCOS, so successfully lowering it with Cabergoline often improves your cycle regularity as well. Those who should avoid it: significant heart valve disease or severe liver impairment. Continue the treatment as prescribed.

Recheck prolactin after 4 weeks. Follow up with your endocrinologist. Repeat MRI pituitary at 6 months to assess adenoma response. Please consult me directly on Practo for a detailed evaluation.