Prolactinomas are pituitary adenomas that secrete excessive prolactin. Prolactin is typically a hormone. Prolactin generally is only secreted in high quantities in women during pregnancy and breastfeeding, as prolactin stimulates breast milk.

Excess prolactin causes reduced GnRH, which leads to diminished reproductive function. Usually, GnRH is produced from the hypothalamus and stimulates the pituitary to produce LH – a luteinizing hormone that stimulates the sex hormone secretion. 

The most common functional pituitary adenoma is prolactinoma. Most prolactinomas occur under age 40 but are uncommon in children. Prolactinomas are more common in women than men and are five times more common in women.

Symptoms of a Prolactinoma

Symptoms in women:

• cessation of menstrual cycles
• Irregular periods 
• Galactorrhea
• Loss of sexual interest
• Infertility
• Osteoporosis

Symptoms in men:

• Erectile dysfunction
• Reduced sex drive or libido
• Infertility
• gynecomastia
• Osteoporosis
• Vision loss

Prolactinoma Diagnosis & Treatment at Dr. Rao’s Hospital

Early diagnosis and intervention will result in a better outcome.

Prolocatinoma diagnostic tests:

• Serum prolactin levels (increased prolactin of > 150 ng/ml = tumor)
• MRI scan

Prolactinoma treatment is mainly medical, and surgery is only if imminent visual loss is present.

The goals of treatment are to:

• Prolactin values normalization
• Stop and reverse the symptoms.
• Hypothyroidism correction
• Remove and destroy the tumor to restore endocrine function to standard and to relieve any symptoms directly related to the tumor.

Medical Therapy

Indefinite treatment is needed for prolactinomas. Medication is effective in 90% of cases. Dopamine agonist drugs are the mainstay of the treatment. Medications shrink the prolactinoma, and some prolactinomas disappear after a few years of therapy. The patient should be on indefinite follow-up.

In women, bromocriptine or cabergoline usually restores menstrual cycles and the ability to conceive. During pregnancy, larger tumors need treatment.

Surgery

If medication fails in about 10%, surgery is the indication. Surgery can be achieved by a transnasal transsphenoidal resection of the tumor, which avoids the brain and eye.

After Successful Surgery

Complete tumor removal resolves the symptoms in many, but testosterone replacement is needed for reproductive function in men with larger tumors.

Radiation Therapy

If the tumor is infiltrative and not able to do total gross removal, then at Dr. Rao’s Hospital, we do:

• Stereotactic Radiosurgery
• External pituitary irradiation

Looking for the best pituitary adenoma surgery for prolactinomas, Dr. Rao’s hospital is the best for the pituitary surgery – trans nasal trans sphenoidal surgery or Stereotactic Radiosurgery; call @9010056444 or 9010057444 for appointment.