Prolactinoma is a condition in which a noncancerous tumor (adenoma) of the pituitary gland in your brain overproduces the hormone prolactin. The major effect of increased prolactin is a decrease in levels of sex hormones — estrogen in women and testosterone in men.
Although prolactinoma isn't life-threatening, it can impair your vision, cause infertility and produce other effects. Prolactinoma is one of several types of tumors that can develop in your pituitary gland.
Doctors can often effectively treat prolactinoma with medications to restore your prolactin level to normal. Surgery to remove the pituitary tumor also may be an option to treat prolactinoma.
Sometimes, there may be no noticeable signs or symptoms from prolactinoma. When signs and symptoms are present, they may be caused by excessive prolactin in your blood (hyperprolactinemia) or, if the tumor is large, from the pressure of the tumor on surrounding tissues. Because elevated levels of the hormone prolactin cause disruption of the reproductive system (hypogonadism), some of the signs and symptoms of prolactinoma are unique for each sex.
In both sexes
Women tend to notice signs and symptoms earlier than men do, when tumors are smaller in size, probably because they're alerted by missed or irregular menstrual periods. Men, on the other hand, tend to notice signs and symptoms later, when tumors are much larger and more likely to cause headache or vision problems.
When to see a doctor
Prolactinoma is one type of tumor that develops in the pituitary gland. The cause of these tumors remains unknown.
The pituitary gland is a small bean-shaped gland located at the base of your brain. Despite its small size, the pituitary gland influences nearly every part of your body. Its hormones, such as prolactin, help regulate important functions such as growth, blood pressure and reproduction.
Other possible causes of prolactin overproduction include medications, other types of pituitary tumors, an underactive thyroid gland, an injury to the chest, pregnancy and breast-feeding.
Pituitary gland and hypothalamus
The pituitary gland and the hypothalamus are situated within the brain and control hormone production. ...
The endocrine system includes the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas, ovaries (in females) and testicles (in men). ...
Most prolactinomas occur in people between 20 and 50 years old. The disorder is rare in children. Pituitary tumors are much more likely in women than in men.
Complications of prolactinoma may include:
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner. However, you may then be referred to a doctor who specializes in disorders that affect your glands and hormones (endocrinologist).
Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with your doctor may be limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For prolactinoma, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
If you have signs and symptoms that suggest you have prolactinoma, your doctor may recommend:
In addition, your doctor may refer you for more extensive testing with a doctor who specializes in treating disorders of the endocrine system (endocrinologist).
Treatments and drugs
Specific goals in the treatment of prolactinoma include:
Prolactinoma treatment consists of two main therapies, medications and surgery:
Doctors use drugs known as dopamine agonists to treat prolactinoma. These drugs mimic the effects of dopamine — the brain chemical that normally controls prolactin production — but are much more potent and long lasting. Commonly prescribed medications include bromocriptine (Parlodel) and cabergoline. These drugs decrease prolactin production and may shrink the tumor in most people with prolactinoma.
Medications and pregnancy
Although these medications are considered safe during pregnancy, doctors generally prefer to keep medications to a minimum while you're pregnant. However, if you have a very large tumor, your doctor may recommend that you stay on your medication during your pregnancy to prevent complications from the prolactinoma. If you're being treated for prolactinoma and you'd like to start a family, it's best to discuss your options with your doctor before you become pregnant.
Medication side effects
If medication effectively shrinks the tumor and your prolactin level remains normal afterward, you may be able to eventually stop taking the medication. Your doctor can offer you advice on when this may be possible for you.
The type of surgery you have depends largely on the size and extent of your tumor:
The outcome of surgery depends on the size and location of the tumor and your prolactin levels before surgery. The higher the prolactin level, the slimmer the chance that your prolactin production will return to normal after surgery. Surgery corrects the prolactin level in most people with small pituitary tumors. However, many pituitary tumors come back within five years of surgery. For people with larger tumors that can only be only partially removed, drug therapy often can return the prolactin level to a normal range after surgery.
Last Updated: 2010-03-06
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