The authors present an update on the various treatment modalities and discuss 
management strategies for prolactinomas. Prolactinomas are the most common type 
of functional pituitary tumor. Effective hyperprolactinemia treatment is of 
great importance, due to its potential deleterious effects including 
infertility, gonadal dysfunction and osteoporosis. Dopamine agonist therapy is 
the first line of treatment for prolactinomas because of its effectiveness in 
normalizing serum prolactin levels and shrinking tumor size. Though withdrawal 
of dopamine agonist treatment is safe and may be implemented following certain 
recommendations, recurrence of disease after cessation of the drug occurs in a 
substantial proportion of patients. Concerns regarding the safety of dopamine 
agonists have been raised, but its safety profile remains high, allowing its use 
during pregnancy. Surgery is typically indicated for patients who are resistant 
to medical therapy or intolerant of its adverse side effects, or are 
experiencing progressive tumor growth. Surgical resection can also be considered 
as a primary treatment for those with smaller focal tumors where a biochemical 
cure can be expected as an alternative to lifelong dopamine agonist treatment. 
Stereotactic radiosurgery also serves as an option for those refractory to 
medical and surgical therapy.