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Prolactinoma and Its Treatment

The most common pituitary adenoma: a prolactin-secreting tumor.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Prolactinoma and Its Treatment?

Prolactinoma is a benign pituitary adenoma that secretes prolactin and accounts for 40-50% of all pituitary adenomas. It is classified as microprolactinoma (<10 mm) or macroprolactinoma (≥10 mm).

In women the most common findings are amenorrhea, galactorrhea (milk discharge), and infertility; in men the typical findings are loss of libido, erectile dysfunction, and gynecomastia. With macroprolactinomas, mass-effect headache and visual field defects may be added.

Unlike other pituitary adenomas, the first-line treatment is medical rather than surgical, using dopamine agonists. Cabergoline is the most commonly used agent and normalizes prolactin and shrinks the tumor in 80-90% of patients.

Symptoms

In women: amenorrhea and galactorrhea
In men: loss of libido and erectile dysfunction
Infertility (in both sexes)
Headache (in macroprolactinoma)
Visual field narrowing (bitemporal hemianopsia)
Osteoporosis (due to prolonged hypogonadism)

Risk Factors

MEN 1 syndrome
Drugs (pseudoprolactinoma — antipsychotics, metoclopramide)
Female sex (microprolactinoma is more common)
Male sex (larger tumor size at diagnosis)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If menstrual irregularity or amenorrhea develops
  • If there is spontaneous milk discharge from the breast
  • If loss of libido and sexual dysfunction occur
  • If headache and visual disturbance develop

Treatment Methods

01
Cabergoline (dopamine agonist — first-line therapy)
02
Bromocriptine (alternative to cabergoline)
03
Surgery (transsphenoidal) — for cases resistant to dopamine agonists
04
Radiotherapy (in rare cases resistant to surgery and medical therapy)
05
Treatment management during pregnancy planning (assessment for cabergoline withdrawal)

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.