Prolactinoma

What is Prolactinoma?

Prolactinoma is a tumor located in the pituitary gland in the brain near the optic nerves that averages 10 mm in length. The good news is that this kind of tumors is  almost always non-cancerous. Prolactinomas still need treatment as they can cause many annoying symptoms and cause complications over time.

These tumors cause the glands to pump too much prolactin, the hormone that makes breast milk, into the bloodstream. The cause of prolactinomas is unknown but women are more prone to get them than men and adults far more than children. It does not seem to be a genetic condition.

What are the Symptoms of Prolactinoma?

Men and women get different symptoms. For women, the most common symptoms are sudden production of breast milk, missed periods, irregular periods, sudden change in blood flow during a period, vaginal dryness which causes pain during vaginal sex, loss of sex drive, painful or sore breasts, headaches and vision problems.

Men may also get headaches, vision problems and loss of sex drive. They also suddenly grow breasts, become impotent and often become infertile.

A particularly large prolactinoma presses down on the optic nerves, causing constant headaches, constant runny nose, nausea, vomiting and numerous vision problems such as tunnel vision or double vision.

It is possible to have a prolactinoma and not have any symptoms. This happens in men more than in women.

Prolactinoma Causes

The actual cause of the tumor on the pituitary gland is unknown. However, the tumor causes the overproduction of prolactin, contributing to the cause of prolactinoma. Because the tumor prevents dopamine, the gland is not able to regulate the release of prolactin. When the pituitary gland is impaired, it cannot support the proper levels of prolactin production, causing prolactinoma.

Medications treating other health issues for high blood pressure, ulcers, depression and heartburn or gastroesophageal reflux also increase the production of prolactin, interfering with the gland function, increasing the risk of prolactinoma. Other health conditions affecting the pituitary gland functions include hypothyroidism, chronic liver and kidney disease, head injuries or brain surgery. Sometimes, radiation treatments, other cancers or injuries near the pituitary gland affect it, triggering prolactinoma.

Genetic testing has linked the hereditary trait of this condition to men, suggesting it is a source for increasing the risk of developing prolactinoma. Corresponding to science, the gene affects only 50% of the children with an affected parent.

How is Prolactinoma Treated?

Medication is often successful in treating a prolactinoma. The type of medication used is called dopamine agonists which help the brain absorb more dopamine, which helps lower prolactin production. Two of the most common dopamine agonists used is bromocriptine and cabergoline. These medications often cause side effects like nausea, dizziness and problems of the heart valves. Doctors may need to perform heart tests on patients before prescribing a dopamine agonist to make sure the heart is healthy enough for the medication.

Radiation such as used for cancer treatment can help shrink a prolactinoma so that prolactin levels fall in the blood and symptoms ease. Radiation also causes side effects.

Brain surgery to remove the tumor is used only in severe cases.

Prolactinoma Prevention

Pituitary tumors are not associated with environmental elements, making it difficult to prevent. They are linked to genetics and the risk levels can be determined through regular blood testing. The testing information helps your doctor in monitoring your prolactin levels as an early preventive measure. Although a cure does not exist, an early-stage tumor may be removed surgically.

Learn more about your family history, since pituitary tumors do run in family genetics. It is important to tell your doctors about your medical history, because most tumors are found by accident.

Further prevention methods include analysis and treatment of underlying causes that contribute to a high production level of prolactin. Treatments or medications affecting the risk of prolactinoma need to be examined by your doctor.