Prolactinoma

Overview

A prolactinoma is a noncancerous tumor of the pituitary gland that causes the gland to produce too much of a hormone called prolactin. This excess prolactin can lead to decreased levels of sex hormones, such as estrogen and testosterone. Prolactinoma is the most common type of hormone-producing tumor that can occur in the pituitary gland. Symptoms can include irregular menstrual periods or no periods in females, breast milk production without pregnancy or breastfeeding, and infertility in both males and females. Treatment options include medications to lower prolactin levels and tumor size, and in some cases, surgery may be necessary to remove the tumor.

Understanding the disease

Symptoms

The symptoms of prolactinoma can vary depending on the individual and the tumor's size. In both females and males, prolactinoma can cause:

1. Irregular menstrual periods or no menstrual periods
2. Milky discharge from the breasts when not pregnant or breastfeeding
3. Painful intercourse due to vaginal dryness
4. Acne and excessive body and facial hair growth In males, prolactinoma can cause:
5. Erectile dysfunction
6. Decreased body and facial hair
7. Smaller muscles
8. Enlarged breasts Pressure from tumor growth can cause:
9. Vision problems
10. Headache
11. Reduction of other hormones produced by the pituitary gland It is essential to consult a healthcare professional for a proper diagnosis and treatment plan if you suspect you have a prolactinoma.

Development

Prolactinoma is a noncancerous tumor of the pituitary gland, which causes the gland to produce excessive amounts of prolactin hormone. The exact cause of prolactinoma is often unknown, but genetic factors may play a role. In some cases, the tumor can be caused by abnormalities in the pituitary gland's cells or by the presence of certain hormones. In general, these tumors develop due to the uncontrolled growth of cells in the pituitary gland.

Assessment and Diagnosis

Triage

You should see a doctor if you suspect a prolactinoma, especially if you experience any of the following symptoms:

• Abdominal pain
• Blood in your stool
• A change in your bowel habits that lasts longer than a week Additionally, if you have risk factors for polyps, such as being age 50 or older or having a family history of colon cancer, you should be screened regularly for polyps.

Diagnosis

To diagnose a prolactinoma, your health care provider may recommend the following tests:

1. Blood tests: Blood tests can show if too much prolactin is being produced. They can also check if other hormones controlled by the pituitary gland are within the standard range. A pregnancy test is usually recommended for females of childbearing age.
2. Brain imaging: Your provider may use a magnetic resonance imaging (MRI) scan of your brain to detect a prolactinoma.
3. Vision tests: These tests can determine if a prolactinoma is affecting your sight. Your provider may also refer you to an endocrinologist, a specialist in treating disorders that affect the endocrine glands and hormones.

Management and Treatment

Complications

Potential complications of prolactinoma include infertility, bone loss (osteoporosis), and vision problems due to pressure from tumor growth causing vision problems, headache, and reduction of other hormones produced by the pituitary gland.

Treatment

Treatments for prolactinoma typically involve medications to decrease prolactin production and shrink the tumor. Medications such as dopamine agonists can help regulate the production of prolactin and reduce tumor size. In some cases, surgery to remove the tumor might be an option as well. It is important to consult with a healthcare professional for personalized treatment recommendations.

Preparing for medical consultation

To prepare for an appointment for prolactinoma, you should:

1. Note down any symptoms you're experiencing, including any that may seem unrelated to the reason for the appointment.
2. Make a list of your menstrual history, including age at onset of periods, episodes of missed menstrual periods, and approximate dates and type of contraceptives used.
3. Write down key personal and medical information, such as other health conditions, recent life changes, and stressors.
4. Create a list of all medications, vitamins, and supplements you're taking, including dosages.
5. Consider bringing a family member or friend for support, as they can help remember information discussed during the appointment.
6. Prepare a list of questions to ask your healthcare provider, such as:
   • What's the most likely cause of my symptoms?
   • What are other possible causes?
   • What tests do I need? Do they require special preparation?
   • What treatments are available, and which do you recommend?
   • What side effects can I expect from treatment?
   • If I have surgery, will the prolactinoma come back?
   • How can I best manage other health conditions together?
   • Will I be able to have children?
   • Is there a generic alternative to the medication you're prescribing? Remember to be open and honest with your healthcare provider about your symptoms and medical history to ensure the best possible care.