ProlactinomaSymptoms, Doctors, Treatments, Advances & More
Learn About Prolactinoma
A prolactinoma is a noncancerous (benign) pituitary tumor that produces a hormone called prolactin. This results in too much prolactin in the blood.
Adenoma - secreting; Prolactin - secreting adenoma of the pituitary
Prolactin is a hormone that triggers the breasts to produce milk (lactation).
Prolactinoma is the most common type of pituitary tumor (adenoma) that produces a hormone. It accounts for about 50% of all pituitary adenomas. Almost all pituitary tumors are noncancerous (benign). Prolactinoma may occur as part of an inherited condition called multiple endocrine neoplasia type 1 (MEN 1).
Prolactinomas occur most commonly in people in their 20s and 30s. They are more common in women than in men and are rare in children.
At least half of all prolactinomas are very small (less than 3/8 of an inch or 1 centimeter [cm] in diameter). These small tumors occur more often in women and are called microprolactinomas. Tumors larger than 3/8 inch (in) or 1 centimeter (cm) in diameter are called macroprolactinomas.
Larger tumors are more common in men. They tend to occur at an older age. The tumor can grow to a large size before symptoms appear.
The tumor is often detected at an earlier stage in young women than in men because the high prolactin causes irregular menstrual periods.
In women:
- Abnormal milk flow from the breast in a woman who is not pregnant or nursing (galactorrhea)
- Breast tenderness
- Decreased sexual interest (libido)
- Decreased peripheral vision
- Headache
- Infertility
- Stopping of menstruation not related to menopause, or irregular menstruation
- Vision changes
In men:
- Decreased sexual interest (libido)
- Decreased peripheral vision
- Enlargement of breast tissue (gynecomastia)
- Headache
- Erection problems (impotence)
- Infertility
- Vision changes
Symptoms caused by pressure from a larger tumor may include:
- Headache
- Lethargy
- Nasal drainage
- Nausea and vomiting
- Problems with the sense of smell
- Sinus pain or pressure
- Vision changes, such as double vision, drooping eyelids, or visual field loss
There may be no symptoms, especially in older men.
Medicine is usually successful in treating prolactinoma. Some people have to take these medicines for life. Other people can stop taking the medicines after 2 to 3 years, especially if their tumor was small (less than 1 cm) when it was discovered or has disappeared from the MRI images. But there is a risk that the tumor may grow and produce prolactin again, especially if it was a large tumor.
A large prolactinoma can sometimes get larger during pregnancy.
Surgery may be done for any of the following:
- Symptoms are severe, such as a sudden worsening of vision
- You are not able to tolerate the medicines to treat the tumor
- The tumor does not respond to medicines
Radiation is usually only used in people with a prolactinoma that continues to grow or gets worse after both medicine and surgery have been tried. Radiation may be given in the form of:
- Conventional radiation
- Gamma knife (stereotactic radiosurgery) -- a type of radiation therapy that focuses high-powered x-rays on a small area in the brain.
California Center For Pituitary Disorders
Dr. Lewis Blevins is an endocrinologist specializing in evaluating and managing pituitary and hypothalamus disorders, including acromegaly, prolactinoma and other pituitary tumors, diabetes insipidus, hypopituitarism and growth hormone deficiencies. As medical director of the California Center for Pituitary Disorders at UCSF Medical Center, he guides a team providing comprehensive, state-of-the-art care. He has a special interest in Cushing's syndrome, also known as hypercortisolism, and has edited a book on the subject. In his research, Blevins is interested in evaluating new methods for diagnosing Cushing's syndrome. He also studies the factors that medical professionals can use to predict whether treating pituitary tumors with surgery or other methods will succeed. Blevins earned a medical degree at Quillen College of Medicine at East Tennessee State University and completed a residency in internal medicine at the University of Alabama at Birmingham Hospitals. After completing a fellowship in endocrinology at the Johns Hopkins Hospital, he served on the faculty at Emory University for four years and at Vanderbilt University for nine years. Dr. Blevins is rated as an Elite provider by MediFind in the treatment of Prolactinoma. His top areas of expertise are Pituitary Tumor, Hypothalamic Tumor, Prolactinoma, and Rathke Cleft Cyst.
USC Brain Tumor Center
Gabriel Zada, MD, MS, FAANS is Professor of Neurological Surgery at the Keck School of Medicine of the University of Southern California and a nationally recognized leader in brain tumor and skull base surgery. He serves as Surgical Director of the USC Brain Tumor Center, Co-Director of the USC Pituitary Center and Radiosurgery Center, and Vice Chair of Education for the Department of Neurosurgery. He is also Editor-in-Chief of Neurosurgical Focus, an international open-access journal of the Journal of Neurosurgery Publishing Group.Dr. Zada specializes in minimally invasive and endoscopic approaches to complex brain, pituitary, and skull base tumors and has performed more than 3,000 cranial operations during his career. His NIH-funded research program focuses on the genomics and epigenetics of brain and pituitary tumors, advancing precision medicine approaches in neurosurgical oncology.A prolific scholar, Dr. Zada has authored over 350 peer-reviewed publications and several textbooks in neurosurgery. Based on independent academic impact and expertise metrics, FindExpertMD ranks him the #1 neurosurgeon in California for multiple tumor (pituitary, meningioma) and skull base conditions and among the top neurosurgeons globally. Dr. Zada is rated as an Elite provider by MediFind in the treatment of Prolactinoma. His top areas of expertise are Pituitary Tumor, Hypothalamic Tumor, Brain Tumor, Endoscopic Transnasal Transsphenoidal Surgery, and Gamma Knife Radiosurgery.
University Andrology Lab LLC
Maria Fleseriu is an Endocrinologist in Portland, Oregon. Dr. Fleseriu is rated as an Elite provider by MediFind in the treatment of Prolactinoma. Her top areas of expertise are Acromegaly, Cushing's syndrome, Cushing's disease, Acromegaloid Facial Appearance Syndrome, and Hormone Replacement Therapy (HRT).
The outlook is usually excellent but depends on the success of medical treatment or surgery. Getting tested to check whether the tumor has returned after treatment is important.
Treatment for prolactinoma may change the levels of other hormones in the body, especially if surgery or radiation is performed.
High levels of estrogen or testosterone may be involved in the growth of a prolactinoma. Women with prolactinomas should be followed closely during pregnancy. They should discuss this tumor with their provider before taking birth control pills with a higher than usual estrogen content.
Untreated pituitary adenomas always have a small risk of suddenly getting bigger, most commonly from bleeding inside the tumor. This is called pituitary apoplexy, and it is a medical emergency. Most people with pituitary apoplexy describe it as having the worst headache of their life.
Contact your provider if you have any symptoms of prolactinoma.
If you have had a prolactinoma in the past, contact your provider for a general follow-up, or if your symptoms return.
Summary: There is a variety of tumors affecting the pituitary gland in childhood; some of these tumors (eg craniopharyngioma) are included among the most common central nervous system tumors in childhood. The gene(s) involved in the pathogenesis of these tumors are largely not known; their possible association with other developmental defects or inheritance pattern(s) has not been investigated. The present...
Summary: Prolactinomas are the most common pituitary adenomas, representing about two-thirds of clinically relevant cases. Their prevalence is around 50 per 100,000 individuals, with an incidence of 3-5 new cases per 100,000 per year and has been rising in recent decades. They may increase morbidity and mortality due to several factors: * Hormone hypersecretion: excess prolactin causes galactorrhea, amenor...
Published Date: April 24, 2025
Published By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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