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Prolactinoma

Last reviewed: 10 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.

  • Prolactinoma images
  • Differentials

    • Nonfunctioning pituitary macroadenomas
    • Drug-induced hyperprolactinemia
    • Primary hypothyroidism
    More Differentials
  • Guidelines

    • ACR appropriateness criteria: neuroendocrine imaging
    • Clinical practice guidelines for the management of aggressive pituitary tumours and carcinomas
    More Guidelines
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