Dopamine agonists are the treatment of choice for prolactinomas. However, there are still controversies concerning dose, treatment
duration and criteria for drug withdrawal in different clinical situations. The aim of this study was to assess diagnostic
and therapeutic approaches to prolactinomas among members of the Brazilian Society of Endocrinology and Metabolism (SBEM).
SBEM members answered a questionnaire sent by e-mail that included 18 questions related to controversial issues about the
management of prolactinomas. Among SBEM members, 721 (approximately 24% of total) answered the questionnaire. Concerning the
diagnosis, 38% of the respondents stated that prolactin levels < 100 ng/ml would exclude the presence of a prolactinoma. Most
of them favored the screening for macroprolactin in asymptomatic individuals instead of a routine screening (74% vs. 26%).
Regarding the treatment, 70% of the respondents chose cabergoline as the drug of choice to treat macroprolactinomas whereas
similar proportions advised cabergoline or bromocriptine as the best treatment for microprolactinomas (52% vs. 48%). Only
20% and 34% of respondents favored treatment withdrawal 2–3 years after prolactin normalization in patients with macroprolactinomas
and microprolactinomas, respectively. In case of pregnancy, only 58 and 70% of respondents advocated discontinuation of treatment
with dopamine agonists in patients with macroprolactinomas and microprolactinomas, respectively. Finally, only 36% would allow
breast-feeding without restriction, 44% would restrict it to patients with microprolactinomas and 20% would not recommend
it for women with prolactinomas There are several points of disagreement among SBEM members regarding the management of prolactinomas.
Keywords Prolactinomas - Hyperprolactinemia - Cabergoline - Bromocriptine