Last reviewed: 22 Aug 2023
Last updated: 22 Jul 2022
Summary
Definition
History and exam
Key diagnostic factors
- amenorrhea or oligomenorrhea
- infertility
- galactorrhea
- 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])
- estrogen 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
- computerized visual-field examination
More 1st investigations to order
Treatment algorithm
ONGOING
premenopausal women
postmenopausal 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.
Differentials
- Nonfunctioning pituitary macroadenomas
- Drug-induced hyperprolactinemia
- Primary hypothyroidism
More DifferentialsGuidelines
- ACR appropriateness criteria: neuroendocrine imaging
- Clinical practice guidelines for the management of aggressive pituitary tumours and carcinomas
More Guidelines
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