About the disease
Prolactinoma is a benign tumor that grows in the pituitary gland (located in the brain). The pituitary gland is very small and shaped like a bean. Its job is to produce hormones, for example for growth, reproduction and regulating blood pressure. Prolactinoma causes the pituitary gland to produce too much of the hormone prolactin, which decreases the levels of sex hormones (testosterone in men and estrogen in women) leading to a low sex drive and behavioral changes.
The most common tumor associated with hormone production, prolactinoma is rarely life threatening. However, it can affect a person’s reproductive system, due to the imbalance in hormones. If the tumor gets very big, it can have a detrimental effect on vision too.
Symptoms of prolactinoma vary for women and men. In females, the most common manifestation of prolactinoma is irregular periods. In some women, menstrual periods disappear altogether. Men may experience erectile dysfunction, due to high levels of prolactin in the blood. In both sexes, prolactinoma can cause infertility.
The cause of prolactinoma has not yet been identified, but doctors think that certain medicines and chest injuries can contribute to its development. According to Mayo Clinic, this condition mostly develops in women aged 20 to 34 years.
Symptoms
- Decreased sex drive
- Unusual hair growth
- Acne in women, in some cases
- Erectile dysfunction in men
- Sore breasts and milk discharge in women
- Vaginal dryness and irregular periods in women
Diagnosis
- During a general examination, the doctor will ask the patient if they have noticed any unusual growth of hair lately.
- If the patient is a woman, the doctor will ask her if she has experienced tenderness in the breasts. If she is of childbearing age, she may be asked to take a pregnancy test.
- The doctor will ask male patients about their sex drive and whether they have experienced erectile dysfunction lately.
- A blood test can help doctors to evaluate the amount of prolactin in the patient’s blood (this will be high in cases of prolactinoma) and can also measure estrogen and testosterone levels.
- Imaging tests of the brain are performed so that doctors can examine the pituitary gland in order to determine whether the patient has prolactinoma.
Treatment
- Conservative treatment is often sufficient to control the levels of prolactin in the patient’s blood. Medicines can be prescribed that eliminate the symptoms and shrink the tumor. It may be necessary to take these medicines for a long period of time, to completely normalize the production of prolactin.
- Surgical resection, whereby the pituitary tumor is completely or partially removed, is recommended if the medicines have been ineffective or if the tumor has put pressure on the surrounding nerves.
Authors: Dr. Vadim Zhiliuk, Dr. Nadezhda Ivanisova
