Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2025
Contraception in adolescents with mental disorders: adherence and satisfaction in the use of depot medroxyprogesterone acetate.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Carneiro Marcela Souza, Garmes Heraldo Mendes, Pravatta-Rezende Gabriela, de Mira Ticiana Aparecida Alves, Yela Daniela Angerame, Benetti-Pinto Cristina Laguna
Аннотация
OBJECTIVE: To evaluate the behavior of pituitary adenomas following cessation of cabergoline (CAB) treatment, postpartum, and postmenopause, in comparison to idiopathic hyperprolactinemia (HPRL).
METHODS: This retrospective cohort study included women with HPRL treated with CAB under three conditions: treatment for at least two years and follow-up for a minimum of one year after treatment discontinuation, postpartum, and postmenopause. The evaluated parameters included tumor size, prolactin (PRL) levels, and clinical symptomatology.
RESULTS: A total of 160 women with idiopathic HPRL, micro- or macroadenomas, with symptom onset at 29.3±9.0 years, were included. Menstrual alterations occurred in 70% and galactorrhea in 63% of cases. PRL normalization occurred more rapidly in idiopathic HPRL than in tumors. However, symptom resolution required a similar time across all groups. All macroadenomas regressed to <10 mm. After CAB withdrawal, reintroduction was necessary in all macroadenomas, 53% of microadenomas, and 23% of idiopathic HPRL. Following postpartum CAB withdrawal, mean serum PRL levels increased by 300% in macroadenomas, 218% in microadenomas, and 11% in idiopathic HPRL; approximately 75% of all patients experienced symptom recurrence. Postmenopausal PRL normalization occurred in over 40% of cases. One untreated idiopathic HPRL case developed a microadenoma 12 months after menopause.
CONCLUSION: HPRL presented a high recurrence rate following CAB discontinuation, regardless of tumor presence or treatment duration, with no reduction in recurrence observed after the postpartum period.
METHODS: This retrospective cohort study included women with HPRL treated with CAB under three conditions: treatment for at least two years and follow-up for a minimum of one year after treatment discontinuation, postpartum, and postmenopause. The evaluated parameters included tumor size, prolactin (PRL) levels, and clinical symptomatology.
RESULTS: A total of 160 women with idiopathic HPRL, micro- or macroadenomas, with symptom onset at 29.3±9.0 years, were included. Menstrual alterations occurred in 70% and galactorrhea in 63% of cases. PRL normalization occurred more rapidly in idiopathic HPRL than in tumors. However, symptom resolution required a similar time across all groups. All macroadenomas regressed to <10 mm. After CAB withdrawal, reintroduction was necessary in all macroadenomas, 53% of microadenomas, and 23% of idiopathic HPRL. Following postpartum CAB withdrawal, mean serum PRL levels increased by 300% in macroadenomas, 218% in microadenomas, and 11% in idiopathic HPRL; approximately 75% of all patients experienced symptom recurrence. Postmenopausal PRL normalization occurred in over 40% of cases. One untreated idiopathic HPRL case developed a microadenoma 12 months after menopause.
CONCLUSION: HPRL presented a high recurrence rate following CAB discontinuation, regardless of tumor presence or treatment duration, with no reduction in recurrence observed after the postpartum period.