Prolactinoma : Causes-Symptoms-Diagnosis-Treatment


 What Is Prolactinoma?

A prolactinoma is a benign (noncancerous) tumor of the pituitary gland that produces a hormone called prolactin. Located at the base of the mind, the pituitary is a pea-sized gland that controls the manufacturing of many hormones.

Prolactin indicators a girl’s breasts to produce milk in the course of being pregnant and breastfeeding. Having too much prolactin in the blood, a situation referred to as hyperprolactinemia, can cause infertility NIH outside link and other troubles. In maximum instances, prolactinomas and associated health issues may be correctly dealt with with medicines.

What Is Prolactinoma?

A prolactinoma happens while some of the cells inside the pituitary gland (those producing prolactin) multiply extra than typical to form a small boom (tumor) in the pituitary gland. The prolactinoma makes an excessive amount of prolactin and this will cause signs and symptoms.

Prolactinomas are commonly very small. Small prolactinomas (less than 10 mm) are referred to as microprolactinomas. Larger ones (extra than 10 mm) are referred to as macroprolactinomas. There is also an unprecedented type called massive prolactinomas, which might be more than 4 cm.

  1. Endocrine system

The endocrine system is a group of glands in various parts of the body that secrete hormones, which are chemical substances that act as messengers to target cells. Hormones influence metabolism, growth and development, sexual function and reproductive processes, and mood. Many hormones are secreted in response to signals from the nervous system. Endocrine disorders can result from overproduction or underproduction of hormones, from changes in hormone sensitivity, or from structural abnormalities in hormone-producing glands.

  1. Pituitary gland

  2. Pineal gland

  3. Thyroid gland

  4. Parathyroid glands

  5. Adrenal glands

  6. Pancreas

Medical terms

  • Prolactinoma is a non-cancerous tumor of the pituitary gland. This tumor causes the pituitary to produce too much hormone called prolactin. The major effect of prolactinoma is decreased levels of sex hormones - estrogen in women and testosterone in men.
  • Prolactinoma is not life-threatening, but it can cause vision difficulties, infertility, and other problems. Prolactinoma is the most common type of tumor that can develop in your pituitary gland.
  • Doctors can often treat prolactinoma by prescribing medications to lower your prolactin level. Surgery might also be an option to remove the tumor from your pituitary gland.
  • A prolactinoma is a type of tumor that is formed in the pituitary gland by excess growth of the hormone prolactin Usually benign they grow slowly over several years and can cause headaches visual problems depression sexual dysfunction and other symptoms If you have any of these symptoms it is important to consult with a doctor to ensure that you do not have a prolactinoma so that treatment can begin right away.

Is a prolactinoma serious?

Prolactinomas are generally not life-threatening but they can cause more serious problems if they grow large enough The symptoms of prolactinoma depend on the presence of a mass within the pituitary gland and whether there is excessive production of prolactin by the tumor They include: Insomnia Headache Visual changes such as double vision or blurred vision Sexual dysfunction including reduced sex drive and erectile dysfunction Nausea and vomiting Abdominal pain and headaches that increase with eating or stress.

Can prolactinoma turn cancerous?

Prolactinoma is a benign tumor that results from the overproduction of the hormone prolactin The excess production of this hormone can lead to lactation or milk secretion in both men and women especially if they are not pregnant or nursing Prolactinomas are quite common with an estimated incidence ranging from 1 to 10 cases per 100,000 people.

Symptoms Prolactinoma

The symptoms of a prolactinoma can vary depending on how much extra prolactin it’s producing and its length and location.

If prolactinoma is not causing any noticeable signs or symptoms, it might still be causing problems. Excessive prolactin can disrupt the reproductive system, which can cause some signs or symptoms. If prolactin is affecting your body in a negative way (hyperprolactinemia), it might be causing pressure on nearby tissues, which can lead to signs or symptoms. The signs and symptoms of a prolactinoma are specific to either females or males.

In females, prolactinoma can cause: -A decrease in menstrual periods -Milk production from the breasts even if you are not breastfeeding-Weight gain-Vision problems

  • No menstrual periods or irregular menstrual periods.

  • When a woman is not pregnant or breast-feeding, she may produce a milky discharge from her breasts.

  • If you have pain during intercourse because your vagina is dry, you can try using a lubricant.

  • Acne and excessive hair growth are common problems that can occur due to hormones.

In males, prolactinoma can cause:

  • Erectile dysfunction

  • Decreased body and facial hair

  • Enlarged breasts, uncommonly

In both sexes, prolactinoma can cause:

  • Low bone density

  • The pituitary gland will reduce other hormone production in response to a tumor.

  • Loss of interest in sexual activity

  • Headaches

  • Visual disturbances

  • Infertility

Women are more likely to notice signs and symptoms early when tumors are smaller in size, since these symptoms may not be noticeable when the tumor is larger. Men are more likely to notice signs and symptoms later when tumors are larger, since these symptoms may include headaches or problems with vision.

When to see a doctor

If you develop signs and symptoms associated with a prolactinoma, see your doctor to find out the cause.

Causes Prolactinoma

Prolactin is a hormone that triggers the breasts to provide milk (lactation).


Prolactinoma is the maximum commonplace kind of pituitary tumor (adenoma) that produces a hormone. It makes up about 30% of all pituitary adenomas. Almost all pituitary tumors are noncancerous (benign). Prolactinoma might also occur as part of an inherited situation called multiple endocrine neoplasia kind 1 (MEN 1).


Prolactinomas arise maximum normally in humans underneath age 40. They are more unusual in women than in guys but are rare in children.


At least half of all prolactinomas are very small (less than 1 centimeter or 3/8 of an inch in diameter). These small tumors occur greater often in ladies and are referred to as microprolactinomas.


Larger tumors are extra commonplace in men. They tend to occur at an older age. The tumor can develop to a large size earlier than signs and symptoms appear. Tumors larger than 3/eight inch (1 cm) in diameter are called macroprolactinomas.


The tumor is often detected at an advanced level in younger girls than in guys due to the fact the high prolactin causes abnormal menstrual intervals.

Prolactinomas are one type of tumor that develop in the pituitary gland. The cause of these tumors is unknown.

The pituitary gland is a small, bean-shaped gland located at the base of your brain. Its hormones play a big role in regulating important functions such as growth, metabolism, blood pressure, and reproduction.

Prolactin overproduction can be caused by medications, other types of pituitary tumors, an underactive thyroid gland, ongoing irritation to the chest, pregnancy, or breast-feeding.

Risk factors Prolactinoma

More prolactinomas occur in women than men. The disorder is rare in children.

Complications Prolactinoma

Complications of a prolactinoma may include: Prolactinomas can cause complications such as:

  • Bone loss (osteoporosis).Too much prolactin can reduce production of the hormones estrogen and testosterone, which can lead to decreased bone density and an increased risk of osteoporosis.

  • Pregnancy complications.Pregnancy produces high levels of estrogen. This can lead to tumor growth if you have a large prolactinoma. Signs and symptoms may include headaches and changes in vision.

  • Vision loss.Prolactinomas can grow large enough to compress your optic nerve. If left untreated, this may result in a loss of peripheral vision.

  • Low levels of other pituitary hormones.If there is too much pressure on the normal pituitary gland, this can lead to lower levels of other hormones that are under the control of the pituitary, including thyroid hormones and cortisol (a stress-response hormone).

If you have prolactinoma, and you want to become pregnant or are already pregnant, talk to your doctor. Your treatment may need to be adjusted in order to facilitate pregnancy.

Prevention Prolactinoma

Unfortunately, there’s not anything you can do to prevent developing a prolactinoma. The most effective hazard for developing a prolactinoma is having an inherited (exceeded via the own family) circumstance called more than one endocrine neoplasia (MEN) type 1.


If you have got a primary-diploma relative (sibling or determine) who has this condition, you could need to undergo genetic testing to check to see if you have it as properly. This may also assist screen for and trap a prolactinoma in its early stages.

How long does it take to treat prolactinoma?

Prolactinomas are benign pituitary tumors that can be treated with medication radiation or surgery In more advanced cases a neurosurgeon may need to remove the entire tumor A doctor will determine which treatment is best for you by examining your medical history and conducting a physical exam Your doctor will likely recommend one of the following treatments: Medication - If you have a prolactinoma that's causing prolactin levels in your blood to rise but hasn't caused any noticeable symptoms your doctor may prescribe medication to lower the amount of the hormone in your body The most common medications used to treat prolactinomas are cabergoline (Cabaser) bromocriptine.

Can prolactinoma be cured?

Prolactinoma is a tumor which develops in the pituitary gland It can cause overproduction of a hormone called prolactin and symptoms related to it The condition is treatable and most people are effectively cured by surgery The treatment however depends on several factors including the degree of the tumor's growth as well as its location in the pituitary gland.

What happens if prolactinoma goes untreated?

Prolactinomas are usually benign and slow-growing in nature When they are not treated they can even regrow after a surgical removal If the tumor's cells begin to multiply uncontrollably excess hormones may be released into the bloodstream causing hypothyroidism and other related conditions These conditions will place a tremendous strain on the body especially since the pituitary gland is responsible for controlling so many different functions such as growth reproduction metabolism and development.

Diagnosis Prolactinoma

You can take a bodily exam, a scientific records questionnaire, and a blood test. If the check indicates a high prolactin level, your blood additionally can be tested to find out how properly your thyroid is working.


If your medical doctor thinks you may have a pituitary tumor, they'll order an MRI (magnetic resonance imaging). This makes use of effective magnets and radio waves to get a clear photograph of your pituitary gland.


If a prolactinoma is observed, you can need extra blood assessments to see if your pituitary gland is making other hormones find it irresistible. You may additionally want extra MRIs to see if the tumor grows and if it responds to remedy.

If you have symptoms that suggest you might have a prolactinoma, your doctor may recommend tests to determine if you have the condition.

  • Blood tests.Blood tests can detect whether the pituitary is producing too much prolactin and whether levels of other hormones are within the normal range. Pregnancy tests can be done in women of childbearing age.

  • Brain imaging.Your doctor may be able to see a tumor on an image of your brain generated by a magnetic resonance imaging scan.

  • Vision tests.These are some things that can indicate if your vision is impaired because of a pituitary tumor.

Your doctor may refer you for more extensive testing with a doctor who specializes in treating disorders of the endocrine system. This may include tests that are beyond the scope of your regular doctor.

Treatment Prolactinoma

Treatment commonly works properly to prevent the signs of prolactinoma and to improve fertility. There are various remedies, however the usual treatment is medicine.

Prolactinoma treatment goals include:

  • Normalize prolactin production.

  • Restore normal pituitary gland function

  • Reduce the size of the pituitary tumor

  • If you have a tumor, try to eliminate any symptoms such as headaches or vision problems.

  • Improve quality of life

Treatment for a prolactinoma usually involves taking medications and having surgery.


Taking oral medications often can decrease the production of prolactin and eliminate symptoms. The medications may also shrink the tumor. However, long-term treatment with medications is generally necessary.

Doctors use drugs that mimic the effects of dopamine to treat prolactinoma. Commonly prescribed medications include bromocriptine (Cycloset Parlodel) and cabergoline.These drugs reduce the production of Prolactin. Prolactin production may shrink the tumor in most people with prolactinoma.

Common side effects

Side effects such as nausea, vomiting, nasal stuffiness, headache, and drowsiness are common with these medications. However, these side effects can often be minimized if your doctor starts you off with a very low dose of the medication and gradually increases it.

There have been rare cases of heart valve damage with cabergoline, but it is usually seen in people taking much higher doses for Parkinson's disease. Some people may develop compulsive behaviors such as gambling while taking these medications.

If the tumor has shrunk significantly and your prolactin level remains normal for two years, your doctor may allow you to taper off the medication. However, recurrence is common. Do not stop taking your medication without your doctor's approval.

Medication during pregnancy

When treating women who want to become pregnant, Bromocriptine is more commonly prescribed. However, once you are pregnant your doctor may tell you to stop taking it.

While both drugs are considered safe in early pregnancy, their safety during later stages of pregnancy isn't known. If you have a large prolactinoma or develop symptoms such as headaches or changes in vision, your doctor may advise restarting your medication to prevent problems. Prolactinoma can lead to complications.

If you're being treated for prolactinoma and you want to get pregnant, it's best to discuss your options with your doctor before you become pregnant.


If drug therapy for prolactinoma doesn't work or you can't tolerate the medication, surgery may be an option. Surgery may be necessary to relieve pressure on the nerves that control your vision.

The type of surgery you have will be based largely on the size and extent of your tumor.

  • Nasal surgery.Most people who need surgery to remove a tumor have it done through the nose. The surgery is called transsphenoidal surgery, and it has low complication rates because it doesn't affect other areas of the brain. There are no visible scars left after the surgery is complete.

  • Transcranial surgery.If your tumor is large or has spread to nearby brain tissue, you may need this procedure called a craniotomy. The surgeon removes the tumor through the upper part of your skull.

The outcome of surgery depends on the size and location of the tumor, as well as your pre-surgery prolactin levels. If your prolactin levels are high, there is a greater chance that production will return to normal after surgery.

Most people with small pituitary tumors have their prolactin level corrected through surgery. However, many people with larger tumors can only have a portion of the tumor removed through surgery, and may need to take medication to return their prolactin level to a normal range.


If you don't respond to medication and your doctor doesn't think surgery is an option, radiation therapy may be an option for you.

Preparing for your appointment

You may first see your family doctor. If needed, you may be referred to a doctor who specializes in disorders that affect the glands and hormones (endocrinologist).

Here is some information to help you prepare for your appointment.

What you can do

  • Write down your symptoms,Make sure to bring any medications or supplements that may be related to the reason for your appointment.

  • When you get your period, write down what happened. This will help you remember in the future.The age at which periods start and the number of missed menstrual periods tend to be around the same dates as when you were using the type of contraceptives you are.

  • Write down key personal information,This might be a difficult assignment for you.

  • List all medications,What vitamins and supplements are you taking?

  • Write down questions for your doctor.

Listing questions that you would like to ask your doctor can help you make the most of your time with him. Some basic questions to ask about a prolactinoma might include:

  • What are the most likely causes of my symptoms?

  • What are other possible causes?

  • What tests will I need? Do I need to do anything special in preparation?

  • What are some treatments available and which would you recommend?

  • What are the potential side effects of my treatment?

  • Can the prolactinoma come back after I have surgery?

  • What are some ways that I can manage my health conditions together?

  • Will I be able to have children?

  • Can I find a similar medicine that does not have the same side effects as the one you're prescribing?

  • Can I take any brochures or other printed material with me? What websites do you think I should visit?

If you have any other questions, feel free to ask.

What to expect from your doctor

Your doctor may ask you questions including:

  • When did your symptoms begin?

  • Has your problem been continuous or occasional?

  • What are some things that might help improve your symptoms?

  • What are the possible side effects of this treatment?

  • Do you or your family members have a history of high calcium levels in your kidneys or tumors in your endocrine glands?

General summary

  1. A prolactinoma is a benign tumor that develops in the pituitary gland located at the base of the brain The pituitary gland is responsible for controlling hormonal activity in the body Prolactinomas are caused by an overproduction of prolactin a hormone that stimulates milk production in women who are breast-feeding Although prolactinomas are usually benign and slow-growing they can cause tumors to grow in other parts of the body including the spine and lungs If a tumor grows large enough it can push on nearby organs and interfere with their function If this occurs surgery may be necessary to remove the tumor.
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