Prolactinoma (cont.)

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What are the types of prolactinomas?

Prolactinomas are usually classified into 2 groups: microadenomas are less than 1 cm while macroadenomas are 1 cm. The size may play a role in symptoms caused by local compression, and may determine the therapy of choice.

What causes a prolactinoma?

Although research continues to find causes of disordered cell growth, the sources of many pituitary tumors, including prolactinomas, still remain unknown.

Most pituitary tumors appear sporadically, meaning that no one else in the family has had a pituitary tumor.

Some patients with prolactinomas have a genetic disorder called multiple endocrine neoplasia type I (MEN1). MEN1 is an inherited condition characterized by a high frequency of peptic ulcer disease and abnormal hormone production from the pancreas, parathyroid, and pituitary glands. Prolactinomas are a characteristic feature of MEN1.

A small number of people have a familial tendency to develop prolactinomas but do not appear to have MEN1. The gene(s) responsible for such cases of prolactinoma have not yet been fully identified.

What symptoms are caused by a prolactinoma?

In women, high blood levels of prolactin usually interfere with ovulation, causing infertility and changing menstruation. In some women, periods may disappear altogether whereas in others, periods become irregular, or menstrual flow may change noticeably. Women who are not pregnant or nursing may begin producing breast milk. Some women may experience a loss of libido (interest in sex). Intercourse may become painful because of vaginal dryness.

In men, the most common symptom of prolactinoma is impotence. Men have no reliable indicator such as menstruation to signal a problem. Thus, many men delay going to the doctor until they have headaches or vision problems, caused by the enlarged pituitary pressing against the nearby nerves from the eyes. Men may not recognize a gradual loss of sexual function or libido. In fact, only after treatment do some men realize they had a problem with sexual function. As a result of later presentation, men on average, have larger prolactinomas at their presentation then women.

Medically Reviewed by a Doctor on 12/20/2013

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