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Beware 2ndary hypoadrenalism due to pituitary failure - no hyperkalaemia, or hypotension as aldosterone still present, no pigmentation as ACTH low, do early morning cortisol (>550)
 
If untreated hyperprolactinaemia causes infertility, and osteoporosis (alters GnRH pulse so LH FSH so Oestrogen deficient), impotence, menstrual disturbance and galactorrhoea
 
Rx prolactinoma - depends on size (do not change life expectancy)
All macro need Rx, if <1cm and aSx - watch as many don't progress, unless infertile, androgen xs (relative) or osteopenia
DA agonist (bromocriptine / Cabergoline) - pre-op or if surgery not curative, use low dose, if higher dose needed may cause cardiac valve fibrosis
Transphenoidal surgery - to decompress optic chiasm - often residual tumour remains
DXT - post-op for residual not medically responding
 
2ndary Amenorrhoea
TFT, FBC, Ferritin, LH FSH, prolactin
??Sheehans - hypogonadotrophic hypogonadism and hypothyroid, low prolactin and low cortisol
?ADH levels