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Drug: Bromocriptine When is Bromocriptine prescribed Bromocriptine is prescribed to women
with hyperprolactinaemia, or excessive prolactin hormone.
What is hyperprolactinaemia When the production of the hormone
prolactin by the pituitary is very excessive (hyperprolactinaemia), it
interferes with the normal secretion of F.S.H. This can result in the development
of oligomenorrhoea or amenorrhoea. Estrogen levels may be low and
"hot flushes" and vaginal dryness and discomfort with intercourse may also
occur. In addition, discharge from the nipple (galactorrhoea) may be a
feature of this condition in about one third of these women.
What are the causes of hyperprolactinaemia Drug therapy including some tranquilizers
and blood pressure lowering agents can raise prolactin levels. In addition,
stress and trauma are factors that lead to a temporary rise in prolactin.
A special X-ray of the area of the skull containing the pituitary gland
or preferably a CAT Scan should be done for all women with a significantly
raised prolactin level. This is done to check whether or not the pituitary
is enlarged, because very occasionally a benign (non-malignant) minute
tumor of the pituitary is responsible for extremely high prolactin
levels. However, even in situations where a tumor is found, the treatment
is medical with Bromocriptine and only very rarely is surgery recommended.
How is Bromocriptine administered The effective dosage of Bromocriptine
is one 2.5 mg tablet 2-3 times per day. However, this dosage is reached
very slowly, usually starting on half a tablet a day and gradually over
a week or so building up the dose. It is however essential that Bromocriptine
be taken on a full stomach, else the result could be intense nausea, vomiting
and diarrhea. Other occasional side effects include dizziness, headaches
and general lassitude. Once you are maintained on the effective dosage
of Bromocriptine, the prolactin level will be rechecked, to confirm that
it has fallen.
For how long should Bromocriptine be continued Bromocriptine is continued each day
until there is evidence on the B.B.T. Chart that a pregnancy may have occurred.
Treatment is then discontinued. The response to treatment including the
re-establishment of a normal menstrual cycle in most women is very rapid.
As long as there is no other cause of the infertility, 80% of women with
hyperprolactinaemia will become pregnant on Bromocriptine. Bromocriptine
has not been shown to cause any problem to the unborn baby. If there is
no evidence of ovulation on Bromocriptine alone, the addition of clomiphene
can be very helpful.
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