Advances in the treatment of prolactinomas

Prolactinomas account for approximately 40% of all pituitary adenomas and are an important cause of hypogonadism and infertility. The ultimate goal of therapy for prolactinomas is restoration or achievement of eugonadism through the normalization of hyperprolactinemia and control of tumor mass. Medical therapy with dopamine agonists is highly effective in the majority of cases and represents the mainstay of therapy. Recent data indicating successful withdrawal of these agents in a subset of patients challenge the previously held concept that medical therapy is a lifelong requirement. Complicated situations, such as those encountered in resistance to dopamine agonists, pregnancy, and giant or malignant prolactinomas, may require multimodal therapy involving surgery, radiotherapy, or both. Progress in elucidating the mechanisms underlying the pathogenesis of prolactinomas may enable future development of novel molecular therapies for treatment-resistant cases. This review provides a critical analysis of the efficacy and safety of the various modes of therapy available for the treatment of patients with prolactinomas with an emphasis on challenging situations, a discussion of the data regarding withdrawal of medical therapy, and a foreshadowing of novel approaches to therapy that may become available in the future

Dietary analysis of women using oral contraceptives

Includes bibliographical references (pages 33-36)This study was carried out with 32 women to determine whether or not women taking oral contraceptives for six consecutive months have a significant increase in food intake. This could result in dietary changes leading to increase in body weight. Controversial data from other researchers suggest that the use of oral contraceptives may result in weight gain. This study was designed to help clarify this controversy.\ud An interview schedule consisting of a 24 hour diet recall was administered. Body weight, caloric intake, protein, fat and carbohydrate consumption before and after contraceptive use were compared statistically. The mean differences for nutrient intake were as follows: protein-0.9 grams, carbohydrates-20.5 grams and fat-1.9 grams. Mean difference for caloric intake was 58.8 Kcal. and the mean difference for weight was 0.5 pounds. The mean dietary intake for protein, carbohydrates, fat, caloric intake and weight were not significantly\ud different.\ud The results obtained provided no substantial evidence of any possible link between use of contraceptive pills and weight, diet, eating habits or changes in eating pattern