Prolactinoma

Last reviewed: 26 Aug 2022
Last updated: 22 Jul 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • amenorrhoea or oligomenorrhoea
  • infertility
  • galactorrhoea
  • loss of sexual desire (libido)
  • erectile dysfunction
  • visual deterioration (e.g., temporal hemianopia)
More key diagnostic factors

Other diagnostic factors

  • osteoporosis
  • ophthalmoplegia
  • headaches
Other diagnostic factors

Risk factors

  • genetic predisposition (e.g., presence of mutation resulting in multiple endocrine neoplasia-1 [MEN-1], familial isolated pituitary adenoma [FIPA])
  • oestrogen therapy
  • male sex, 30 to 60 years of age
  • female sex, 20 to 50 years of age
More risk factors

Diagnostic investigations

1st investigations to order

  • serum prolactin
  • pituitary MRI
  • computerised visual-field examination
More 1st investigations to order

Treatment algorithm

ONGOING

pre-menopausal women

post-menopausal women

men

Contributors

Authors

Niamh Martin, MB ChB, PhD, FRCP

Reader in Endocrinology

Imperial Centre for Endocrinology

Department of Metabolism, Digestion and Reproduction

Imperial College London

London

UK

Disclosures

NM declares that she has no competing interests.

Acknowledgements

Dr Niamh Martin would like to gratefully acknowledge Dr Ilan Shimon, the previous contributor to this topic.

Disclosures

IS receives consultancy and lecturing fees from Pfizer, Israel, and is an author of a number of references cited in this topic.

Peer reviewers

Mark Molitch, MD

Professor

Division of Endocrinology

Northwestern University Feinberg School of Medicine

Chicago

IL

Disclosures

MM is an author of a number of references cited in this topic.

  • Prolactinoma images
  • Differentials

    • Non-functioning pituitary macroadenomas
    • Drug-induced hyperprolactinaemia
    • Primary hypothyroidism
    More Differentials
  • Guidelines

    • Position statement for clinical practice: prolactin-secreting tumors
    • Clinical practice guidelines for the management of aggressive pituitary tumours and carcinomas
    More Guidelines
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