What is a Prolactinoma?

A Prolactinoma is a benign pituitary tumor that secretes too much Prolactin, the hormone that normally stimulates milk production after childbirth.

Symptoms in Women:

• Galactorrhea: Milky discharge from breasts (even if not pregnant/breastfeeding).
• Irregular or Absent Periods (Amenorrhea).
• Infertility.
• Decreased Libido.

Symptoms in Men:

• Erectile Dysfunction.
• Low Testosterone (Hypogonadism): Fatigue, loss of muscle, decreased libido.
• Gynecomastia (breast enlargement).
• NOTE: Men often present late because symptoms are more subtle. Tumors are often larger at diagnosis (macroadenomas).

Diagnosis:

• Prolactin Level: Very high (usually >100-200 ng/mL). The higher the level, the more likely it's a prolactinoma.
• MRI: Confirms the tumor.

Treatment:

• Dopamine Agonists: Cabergoline (Dostinex) or Bromocriptine. These shrink the tumor AND lower prolactin in >90% of cases.
• Surgery: Rarely needed (only if meds don't work or intolerable side effects).
• Pregnancy: Women can safely conceive on Cabergoline. It's usually stopped once pregnant, and the tumor rarely grows during pregnancy.

Good News: Prolactinomas respond better to medication than any other pituitary tumor!