They are the first-line treatment and include two agents: Bromocriptine and Cabergoline. They act by increasing dopamine concentration which inhibits the production and secretion of prolactin in the anterior pituitary gland. Bromocriptine follows a daily regimen, to be taken with food to minimize gastrointestinal side effects.
As mentioned, hyperprolactinemia causes a decrease in estradiol which drags on the various ailments. Supplementing with estrogen and progesterone therapy may be an option in women who cannot tolerate dopamine agonist treatment for whatever reason.
Surgery and radiation therapy are options in cases where prolactinoma is resistant to dopamine agonist treatment, or when there is a relapse after discontinuation of treatment. Both interventions aim to reduce the size of the pituitary gland which will reduce production and secretion. Radiation may be less effective because it takes time to see effects and is often a second choice after surgery.