National Organization for Rare Disorders, Inc.
It is possible that the main title of the report Prolactinoma is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.
- amenorrhea-galactorrhea, nonpuerperal
- Forbes-Albright syndrome
- galactorrhea-amenorrhea syndrome
- nonpuerperal galactorrhea
Related Disorders List
Information on the following diseases can be found in the Related Disorders section of this report:
A prolactinoma is a benign tumor of the pituitary gland (adenoma) that produces an excessive amount of the hormone prolactin. In women, hyperprolactinemia is characterized by irregular menstrual periods (amenorrhea), infertility and production of breast milk in women who are not pregnant (galactorrhea). The most common symptom in men is impotence.
Many of the symptoms of prolactinoma are caused by an excessive amount of prolactin in the blood (hyperprolactinemia). In women, prolactinoma is characterized by irregular menstrual periods (amenorrhea), infertility and production of breast milk in women who are not pregnant (galactorrhea). Some women experience diminished sexual desire or painful intercourse. The most common symptom in men is impotence.
Some symptoms such as headaches and vision abnormalities are caused by pressure from the pituitary tumor on other tissues and the optic chiasm.
The cause of pituitary tumors is unknown. Most pituitary tumors are sporadic and not associated with genetic factors that are inherited or can be passed on to children.
Pituitary tumors that produce enough prolactin to affect health occur in approximately 14 out of 100,000 people.
All patients who are shown to have a pituitary adenoma on MRI or CT imaging should have a serum prolactin level checked as if their prolactin level is >250 ng/ml the patient likely harbors a prolactin secreting tumor which should be treated with a dopamine agonist rather than surgery. If the tumor is <10 mm then there is a grey zone of a mildly elevated prolactin level which may represent a lack of normal inhibition by hypothalamic dopamine which then permits the normal prolactin secreting cells to hypersecrete. A specialist consultation should be considered for such patients by an experienced endocrinologist. Comparisons with the following conditions may be useful for a differential diagnosis:
Chiari-Frommel syndrome is a rare endocrine disorder that affects women who have recently had a child (postpartum) and is characterized by the production of breast milk (lactation), lack of ovulation (anovulation), and the absence of regular menstrual periods (amenorrhea). These symptoms persist long after childbirth. The absence of normal hormonal cycles may result in a reduction in the size of the uterus (atrophy). Other symptoms may include emotional distress, anxiety, headaches, backaches, abdominal pain, and occasionally obesity. (For more information on this disorder, choose "Chiari-Frommel" as your search term in the Rare Disease Database.)
Ahumada-del Castillo syndrome is a rare endocrine disorder characterized by the abnormal function of the hypothalamus and pituitary glands affecting the secretion of hormones. This disorder affects only women and is not related to pregnancy. The two major symptoms of this disorder include the production and expression of milk from the breasts not associated with childbirth or nursing, and the absence of regular menstruation. There is normal development of secondary sexual characteristics. (For more information on this disorder, choose "Ahumada-del Castillo" as your search term in the Rare Disease Database.)
Hypothyroidism is a condition characterized by abnormally decreased activity of the thyroid gland and deficient production of thyroid hormones. The thyroid gland secretes hormones that play an essential role in regulating growth, maturation, and the rate of metabolism. Specific symptoms and findings associated with hypothyroidism may be variable, depending upon the age at symptom onset, the degree of thyroid hormone deficiency, and/or other factors. In many adults with hypothyroidism, the condition may be characterized by generalized fatigue and lack of energy (lethargy), muscle weakness and cramping, dryness of the skin and hair, incomplete or infrequent passing of stools (constipation), sensitivity to cold, and other symptoms. Individuals with hypothyroidism sometimes have hyperprolactinemia that can cause reproductive disorders. (For more information on this disorder, choose "hypothyroidism" as your search term in the Rare Disease Database.)
Many drugs are known to cause hyperprolactinemia, including dopamine-receptor antagonists (phenothiazines, butyrophenones, thioxanthenes, risperidone, metoclopramide, sulpiride, pimozide), dopamine-depleting agents (methyldopa, reserpine) and others such as isoniazid, danazol, tricyclic antidepressants, monoamine antihypertensives, verapamil, estrogen, antiandrogens, cyproheptadine, opiates, H2-blockers and cocaine.
Prolactinoma is treated with medications that act like dopamine (dopamine agonists) such as bromocriptine and cabergoline because dopamine inhibits prolactin secretion. These medications reduce the size of the tumor and reduce the amount of prolactin secretion in approximately 80% of patients. Surgery may be recommended if medical therapy is not effective. Pituitary tumors recur after surgery in some affected individuals.
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Serri O, Chik CL, Ur E, Ezzat S. Diagnosis and management of hyperprolactinemia. CMAJ. 2003;169(6):575-81.
Biller BM, Luciano A, Crosignani PG, et al. Guidelines for the diagnosis and treatment of hyperprolactinemia. J Reprod Med. 1999;44(12 Suppl):1075-84.
Conner P, Fried G. Hyperprolactinemia; etiology, diagnosis and treatment alternatives. Acta Obstet Gynecol Scand. 1998;77(3):249-62.
Davies PH. Drug-related hyperprolactinaemia. Adverse Drug React Toxicol Rev. 1997;16(2):83-94.
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Prolactinoma. National Endocrine and Metabolic Diseases Information Service. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). http://endocrine.niddk.nih.gov/pubs/prolact/prolact.aspx. Updated May 2009. Accessed March 27, 2012.
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It is possible that the title of this topic is not the name you selected. Please check the Synonyms listing to find the alternate name(s) and Disorder Subdivision(s) covered by this report
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Last Updated: 3/29/2012
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