Last reviewed: 22 Nov 2024
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)
Full details
Other diagnostic factors
- osteoporosis
- ophthalmoplegia
- headaches
Full details
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
Full details
Diagnostic tests
1st tests to order
- serum prolactin
- pituitary MRI
- computerized visual-field examination
Full details
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
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer