Summary

• Prolactinomas represent approximately 40% of all pituitary adenomas, with a female preponderance.
• Women usually present with amenorrhoea and galactorrhoea. Men may present with sexual dysfunction, hypogonadism and sometimes gynaecomastia, all related to the hyperprolactinaemia.
• Premenopausal women present earlier due to menstrual irregularity and hence usually have microprolactinomas. Men and post-menopausal women often present later with macroadenomas, which may be invasive or giant tumours.
• Treatment with dopamine agonists usually results in prolactin normalisation, symptom improvement, and tumour shrinkage.