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 macro-adenomas, which may be invasive or giant tumours.
Treatment with dopamine agonists usually results in prolactin normalisation, symptom improvement, and tumour shrinkage.
Prolactinomas are benign lactotroph adenomas expressing and secreting prolactin.
History and exam
Niamh Martin, MB ChB, PhD, FRCP
Clinical Senior Lecturer in Endocrinology
Imperial Centre for Endocrinology
Department of Medicine
Imperial College London
NM declares that she has no competing interests.
Dr Niamh Martin would like to gratefully acknowledge Dr Ilan Shimon, the previous contributor to this topic.
IS receives consultancy and lecturing fees from Pfizer, Israel, and is an author of a number of references cited in this topic.
Mark Molitch, MD
Division of Endocrinology
Northwestern University Feinberg School of Medicine
MM is an author of a number of references cited in this topic.
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