Prolactinoma What we need to know

04.01.2024

Prolactinoma is a benign tumor of the pituitary gland that causes excessive secretion of the hormone prolactin. The effects of prolactinoma are manifested by a decrease in the production of sex hormones - estrogens and testosterones. The exact cause of the development of prolactinoma is unknown.

Table of Contents

The pituitary gland is a small, walnut-shaped gland, which is located in a bony structure located at the base of the brain - the Turkish hump. The anterior lobe of the pituitary gland (adenohypophysis) produces prolactin, along with the other 5 hormones. The posterior lobe of the pituitary gland - the neurohypophysis also produces 2 hormones.

Pituitary hormones control the functions of almost all endocrine glands in the body.

Prolactinoma as a tumor is not life-threatening, however, it causes vision impairment, infertility, headaches and others.

Symptoms

Prolactinoma may be asymptomatic. Clinical manifestations are caused by hyperprolactinemia - an increase in the concentration of prolactin in the blood, as well as in the case of a large tumor - pressure on the surrounding tissues.

Since the excessive secretion of prolactin has a direct depressing effect on the reproductive system, the symptoms appear differently in women and men:

In women:

Irregular cycle or its absence
Discharge from mammary glands (regardless of pregnancy or lactation period)
Vaginal dryness
Acne and facial hair

In men:

erectile dysfunction
Reduction of facial and body hair
Muscle hypotrophy
Increase in breast size

In both women and men, it is worth noting:

Infertility
Osteoporosis (bone mineralization disorder)
Decreased sexual activity (libido).

An increase in tumor volume and pressure on the surrounding tissues causes:

vision impairment
headaches
decrease in the production of other hormones of the pituitary gland

Premenopausal women notice prolactinoma symptoms much earlier than postmenopausal women. The reason for this is that an irregular cycle attracts attention. Men also tend to notice symptoms later.

When to see a doctor?

When the patient notices the above symptoms, or when prolactinoma is diagnosed, hormone therapy is necessary for pregnancy planning, for which he must consult a doctor.

Pituitary gland and hypothalamus

It is an important organ in the brain that controls the release of pituitary hormones and also ensures the body's homeostasis - maintaining the stability of organ systems (body temperature, blood pressure, mood, sleep, hunger, thirst, etc.).

Endocrine System

The endocrine system includes the following glands: pituitary gland, thyroid, parathyroid glands, adrenal glands, pancreas, ovaries, testicles.

In prolactinoma, the prolactin produced in excess affects the level of sex hormones.

In addition to prolactinoma, excessive production of prolactin may be caused by other reasons:

Medications
Other pituitary tumors (adenomas)
Kidney diseases
Decreased function of the thyroid gland
Pregnancy and lactation

Risk factors

Prolactinomas are more common in women. It is relatively rare in children.

Rarely, it can be a manifestation of congenital pathology – multiple endocrine neoplasia type I.

Complications

Ø Infertility

Ø Osteoporosis and simultaneous spontaneous fractures

Ø Pregnancy complications - an increase in estrogen levels may develop during pregnancy, which may become the cause of tumor growth. This causes deterioration of vision and unbearable fever pains in pregnant women.

Ø Loss of vision – if left untreated, the tumor puts pressure on the retina, which may cause irreversible damage.

Ø Decrease in the secretion of other hormones of the pituitary gland - especially thyroid-stimulating (TSH) and corticotropic hormone secretion disorders become the cause of a number of pathologies.

Treatment

Treatment of prolactinoma is mainly medical - to decrease the prolactin level and reduce the size of the tumor. However, in some cases there is a need to surgically remove the bulky formation.

Prolactin