Prolactinoma

Overview

Prolactinoma is a benign tumor of the pituitary gland that overproduces prolactin, a hormone primarily associated with milk production and the development of mammary glands. This excess of prolactin leads to reduced levels of sex hormones like estrogen and testosterone, potentially causing symptoms such as vision problems, infertility, and other health issues. Despite these challenges, prolactinomas are the most prevalent type of hormone-secreting pituitary tumors and are not considered life-threatening.

Prolactin, also known as lactotropin, is essential for several physiological processes beyond lactation, including the function of the immune and central nervous systems, as well as reproductive health. It is normally produced in the pituitary gland, although other parts of the body like the central nervous system, uterus, and mammary glands can also produce it. Typical prolactin levels are low in non-pregnant, non-lactating individuals, and those assigned male at birth, but are naturally higher during pregnancy and breastfeeding.

Treatment for prolactinoma usually involves medication to normalize prolactin levels and reduce the size of the tumor. In cases where medication is ineffective, surgery might be considered to remove the tumor. Managing prolactin levels is crucial as prolonged high levels, a condition known as hyperprolactinemia, can lead to significant health complications, including infertility.

Symptoms

Certain prolactinomas are specific to either males or females due to the fact that an excess of prolactin can produce hypogonadism, a disruption of the reproductive system. The sign and symptoms of prolactinoma can differ based on its size, location, and excess prolactin production.

• Females:
  • A milky discharge coming from the breasts while you’re not nursing or pregnant.
  • Excessive face and body hair growth and acne.
  • No menstrual cycle or irregular menstruation.
  • Painful sexual intercourse due to dry vagina.
• Male:
  • Decreased in facial and body hair
  • Enlarged breasts.
  • Erectile dysfunction
  • Smaller muscles
• Both female and male:
  • Decrease in the pituitary gland’s production of other hormones.
  • Headache
  • Infertility
  • Loss of interest in sexual activity
  • Nausea and vomiting.
  • Osteoporosis or weak bones that break easily.
  • Vision problems

Premenopausal women typically become aware of signs and symptoms early, while tumors are still tiny. Missed or irregular menstrual periods are most likely responsible for this.

Postmenopausal women are more prone to experience headaches and vision issues later in life, when tumors are larger and more likely to produce symptoms. Additionally, men are more likely to detect signs and symptoms later.

Consult a healthcare provider if you notice symptoms suggestive of a prolactinoma to determine the underlying cause. If you’re planning to conceive or are already pregnant with a prolactinoma, it’s essential to discuss with a healthcare provider for potential adjustments in treatment and monitoring.

Causes

It is typically unknown what causes prolactinoma. The tumor that grows in the pituitary gland is called prolactinoma. The pituitary gland produces excessive amounts of the hormone prolactin when there is a prolactinoma. This causes a reduction in the levels of various sex hormones, specifically testosterone and estrogen.

Hyperprolactinemia, or the overproduction of prolactin, can occur for reasons other than prolactinoma. These may consist of:

• Breastfeeding or pregnancy.
• Hypoactive thyroid gland
• Kidney disease
• Medications
• Other types of pituitary tumors

Risk factors

The following risk factors for prolactinomas may include the following:

• Gender: The condition is more common to occur with female than male. The condition is rare in children and adolescent.
• Age: People under 40 are usually affected with prolactinomas.
• Others disease: Rarely, a hereditary condition such multiple endocrine neoplasia, type 1 (which results in tumors in hormone-producing glands) can increase the chance of developing a prolactinoma.