Prolactinoma: Levels, Symptoms & Treatment

What is Prolactinoma?

Prolactinoma is a non-cancerous tumour that forms in the pituitary gland. The tumour causes excess production of a hormone called prolactin. Prolactin is produced in the pituitary gland located at the base of your brain. This hormone is responsible for the development of mammary glands and milk production.

Prolactinoma is a common type of tumour. It is not life-threatening and can be treated with the help of medications and, in some cases, surgery. It commonly occurs in women under 40 years. Prolactinomas are usually small and are called micro prolactinomas. Larger prolactinomas occur in older men and are called macro prolactinomas.

Read on to learn more about the prolactinoma symptoms, causes, tests and prolactinoma treatments.

What Are the Symptoms of Prolactinoma?

Prolactinoma symptoms depend on the size and location of the tumour and the quantity of excess prolactin it produces.

Symptoms of prolactinoma in women include the following:

• Changes in menstruation (irregular periods or no periods)
• Discharge of milk from nipples in women who are not pregnant
• Lack of interest in sexual intimacy
• Pain and discomfort during intercourse due to vaginal dryness

Symptoms of prolactinoma in men include the following:

• Lack of interest in sexual intimacy due to low levels of testosterone
• Erectile dysfunction
• Infertility
• Milky discharge from nipples
• Gynecomastia or enlarged breast tissue

In the case of macro prolactinoma, the symptoms are:

• Headache
• Nausea
• Double vision and decreased peripheral vision
• Sinus pain
• Poor sense of smell

Women notice symptoms of prolactinoma earlier due to changes in their periods and milky discharge in the absence of pregnancy. However, menopausal women and men are diagnosed later as the signs and symptoms are unclear.

What Are the Causes of Prolactinoma?

The exact cause of prolactinoma is unknown.

Some genetic factors may be responsible for the condition. For instance, multiple endocrine neoplasia type 1. It is an inherited disorder that causes tumours in hormone-producing glands and may increase the risk of prolactinoma.

How Is Prolactinoma Diagnosed?

Prolactinoma is detected earlier in women due to irregular periods and milky discharge in the absence of pregnancy.

If you observe symptoms of prolactinoma, please consult your doctor at the earliest. They will recommend the following blood tests and imaging tests to determine the condition and plan appropriate treatment.

• Prolactin Level Blood Test

This test measures the level of prolactin in your blood. If the levels are higher, your doctor will advise imaging tests to confirm the diagnosis.

• Testosterone Level Blood Test

For men experiencing prolactinoma symptoms, your doctor will advise this blood test to measure the testosterone level in your blood. If you have low levels of testosterone in your blood, it will confirm prolactinoma diagnosis.

• Magnetic Resonance Imaging (MRI) Scan

Your doctor will advise an MRI scan of your brain to detect a prolactinoma. In this procedure, radio waves and magnets create detailed images of your brain, which helps your doctor locate the tumour and determine its size.

• Computed Tomography (CT) Scan

Your doctor will recommend a CT scan if you have a pacemaker or metal implants. This procedure uses a series of X-ray images and a computer to create images of your brain. This procedure helps locate the prolactinoma and study its size.

• Vision Test

If you are diagnosed with macro prolactinoma or a large tumour, your doctor will advise a vision test to determine if your vision has been affected.

What Are the Treatment Options for Prolactinoma?

Your doctor will plan your prolactinoma treatment based on the diagnostic tests. They will typically prescribe medications.

The aim of the treatment will be to

• Bring your prolactin levels to normal
• Reduce the size of the tumour
• Ensure the healthy functioning of the pituitary gland
• Eliminate the issues caused by the tumour, like irregular periods, low testosterone levels and vision problems.

Medications for Prolactinoma

• Dopamine Agonists

These medications control the prolactin levels, bring them to normal and reduce the size of the tumours. These also help reduce prolactinoma symptoms.

Your doctor will direct you to take these medications for at least 2 years to ensure the tumour does not grow again.

Your doctor will reduce the medications gradually after 2 years if your prolactin levels have returned to normal and the tumour is not visible. If your prolactin levels increase again, your doctor will advise you to continue the medications until the levels normalise.

Please do not stop taking your medications without consulting your doctor.

Surgery for Prolactinoma

Your doctor may advise surgery if

• You experience side effects from the medications
• The tumour does not shrink with the medications
• You have a large prolactinoma, and you want it removed
• To relieve the pressure of the tumour on optic nerves

Surgeries to remove the tumour are listed below.

• Transsphenoidal

Doctors perform this surgery through a small cut at the back of your nasal cavity.

• Transcranial

Doctors perform this surgery in case of a large tumour. In this procedure, they remove the tumour through an opening in the skull.

Radiation Therapy for Prolactinoma

In rare cases, your doctor will advise radiation therapy if the medications do not have the desired effect, if you do not wish to undergo surgery or if part of the tumour cannot be removed with surgery.

During radiation therapy, high-energy waves are used to kill the tumour cells. Your doctor will advise radiation therapy based on the size and location of your tumour.

Summing up

Please consult your doctor at the earliest if you observe a milky discharge from your nipples, if you are not pregnant or lactating. Similarly, consult your doctor if you notice any changes in your periods or if your periods stop even if you are not menopausal. While having prolactinoma is a cause for concern, please do not worry. The condition is highly treatable with medications and, in some cases, surgery. If your doctor advises prolactin or testosterone blood tests for detecting prolactinoma, please get the tests done from a certified pathology lab. Metropolis India is trusted by doctors and hospitals and promises highly professional testing and accurate results.