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</div><div><span>Prolactinoma</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Prolactinoma</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>A prolactinoma is a noncancerous (benign) pituitary tumor that produces a hormone called prolactin. This results in too much prolactin in the blood.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Prolactin is a hormone that triggers the breasts to produce milk (lactation).</p><p>Prolactinoma is the most common type of <a test="test" href="./000704.htm">pituitary tumor</a> (adenoma) that produces a hormone. It makes up about 30% of all pituitary adenomas. Almost all pituitary tumors are noncancerous (benign). Prolactinoma may occur as part of an inherited condition called <a test="test" href="./000398.htm">multiple endocrine neoplasia type 1</a> (MEN 1).</p><p>Prolactinomas occur most commonly in people under age 40. They are more common in women than in men and are rare in children.</p><p>At least half of all prolactinomas are very small (less than 3/8 of an inch or 1 centimeter [cm] in diameter). These small tumors occur more often in women and are called microprolactinomas.</p><p>Larger tumors are more common in men. They tend to occur at an older age. The tumor can grow to a large size before symptoms appear. Tumors larger than 3/8 inch (1 cm) in diameter are called macroprolactinomas.</p><p>The tumor is often detected at an earlier stage in young women than in men because the high prolactin causes irregular menstrual periods.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>In women:</p><ul><li>
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Abnormal milk flow from the breast in a woman who is not pregnant or nursing (<a test="test" href="./001515.htm">galactorrhea</a>)</li><li>Breast tenderness</li><li>Decreased sexual interest (libido)</li><li>Decreased peripheral vision</li><li>Headache</li><li><a test="test" href="./001191.htm">Infertility</a></li><li>Stopping of menstruation not related to <a test="test" href="./000894.htm">menopause</a>, or irregular menstruation</li><li>Vision changes</li></ul><p>In men:</p><ul><li>
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Decreased sexual interest (libido)</li><li>Decreased peripheral vision</li><li><a test="test" href="./003165.htm">Enlargement of breast tissue</a> (gynecomastia)</li><li>Headache</li><li><a test="test" href="./007617.htm">Erection problems</a> (impotence)</li><li>Infertility</li><li>Vision changes</li></ul><p>Symptoms caused by pressure from a larger tumor may include:</p><ul><li>
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Headache</li><li><a test="test" href="./003088.htm">Lethargy</a></li><li>Nasal drainage</li><li>Nausea and vomiting</li><li>Problems with the sense of smell</li><li>Sinus pain or pressure</li><li>Vision changes, such as double vision, <a test="test" href="./003035.htm">drooping eyelids</a>, or visual field loss</li></ul><p>There may be no symptoms, especially in older men.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your health care provider will perform a physical exam and ask about your symptoms. You will also be asked about medicines and substances you are taking.</p><p>Tests that may be ordered include:</p><ul><li>Pituitary MRI or <a test="test" href="./003786.htm">brain CT scan</a></li><li><a test="test" href="./003707.htm">Testosterone</a> level in men</li><li><a test="test" href="./003718.htm">Prolactin</a> level</li><li><a test="test" href="./003444.htm">Thyroid function</a> tests (important because an underactive thyroid can mimic a prolactinoma - pseudoprolactinoma)</li><li>Other tests of pituitary function</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Medicine is usually successful in treating prolactinoma. Some people have to take these medicines for life. Other people can stop taking the medicines after 2 to 3 years, especially if their tumor was small (less than 1 cm) when it was discovered or has disappeared from the MRI images. But there is a risk that the tumor may grow and produce prolactin again, especially if it was a large tumor.</p><p>A large prolactinoma can sometimes get larger during pregnancy.</p><p>Surgery may be done for any of the following:</p><ul><li>Symptoms are severe, such as a sudden worsening of vision</li><li>You are not able to tolerate the medicines to treat the tumor</li><li>The tumor does not respond to medicines</li></ul><p>Radiation is usually only used in people with a prolactinoma that continues to grow or gets worse after both medicine and surgery have been tried. Radiation may be given in the form of:</p><ul><li><a test="test" href="./001918.htm">Conventional radiation</a></li><li><a test="test" href="./007577.htm">Gamma knife (stereotactic radiosurgery)</a> -- a type of radiation therapy that focuses high-powered x-rays on a small area in the brain. </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>The outlook is usually excellent but depends on the success of medical treatment or surgery. Getting tested to check whether the tumor has returned after treatment is important.</p><p>Treatment for prolactinoma may change the levels of other hormones in the body, especially if surgery or radiation is performed.</p><p>High levels of estrogen or testosterone may be involved in the growth of a prolactinoma. Women with prolactinomas should be followed closely during pregnancy. They should discuss this tumor with their provider before taking birth control pills with a higher than usual estrogen content.</p><p>Untreated pituitary adenomas always have a small risk of suddenly getting bigger, most commonly from bleeding inside the tumor. This is called pituitary apoplexy, and it is a medical emergency. Most people with pituitary apoplexy describe it as having the worst headache of their life.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>See your provider if you have any symptoms of prolactinoma.</p><p>If you have had a prolactinoma in the past, contact your provider for a general follow-up, or if your symptoms return.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Adenoma - secreting; Prolactin - secreting adenoma of the pituitary</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1093t.jpg" alt="Endocrine glands" title="Endocrine glands" class="side-img"/><a href="../imagepages/1093.htm">Endocrine glands</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Bronstein MD, Glezer A. Prolactinomas and disorders of prolactin secretion. In: Robertson RP, ed. <em>DeGroot's Endocrinology</em>. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 35.</p><p>Cooper PE, Van Uum SHM. Neuroendocrinology. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. <em>Bradley and Daroff's Neurology in Clinical Practice</em>. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 50.</p><p>Tirosh A, Shimon I. Current approach to treatments for prolactinomas. <em>Minerva Endocrinol</em>. 2016;41(3):316-323. PMID: 26399371 <a href="https://www.ncbi.nlm.nih.gov/pubmed/26399371/" target="_blank">www.ncbi.nlm.nih.gov/pubmed/26399371/</a>.</p></div></div></section>
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