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Prolactinoma

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 24 Sep 2025
Last updated: 22 Jul 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • amenorrea u oligomenorrea
  • infertilidad
  • galactorrea
  • pérdida del deseo sexual (libido)
  • disfunción eréctil
  • deterioro visual (p. ej., hemianopsia temporal)
Full details

Other diagnostic factors

  • osteoporosis
  • oftalmoplejía
  • cefaleas
Full details

Risk factors

  • predisposición genética (p. ej., presencia de una mutación que causa el síndrome de neoplasia endocrina múltiple tipo 1 [MEN-1] o adenoma hipofisario hereditario aislado [FIPA])
  • terapia con estrógenos
  • sexo masculino, de 30 a 60 años de edad
  • sexo femenino, de 20 a 50 años de edad
Full details

Diagnostic investigations

1st investigations to order

  • prolactina sérica
  • resonancia magnética (IRM) hipofisaria
  • examen computarizado del campo visual
Full details

Treatment algorithm

ONGOING

mujeres en la etapa de la premenopausia

mujeres en la etapa de la posmenopausia

hombres

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Wildemberg LE, Fialho C, Gadelha MR. Prolactinomas. Presse Med. 2021 Dec;50(4):104080.Full text  Abstract

Melmed S, Casanueva FF, Hoffman AR, et al; Endocrine Society. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Feb;96(2):273-88.Full text  Abstract

Xia MY, Lou XH, Lin SJ, et al. Optimal timing of dopamine agonist withdrawal in patients with hyperprolactinemia: a systematic review and meta-analysis. Endocrine. 2018 Jan;59(1):50-61. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Prolactinoma images

  • Differentials

    • Macroadenomas hipofisarios no funcionales
    • Hiperprolactinemia inducida por fármacos
    • Hipotiroidismo primario
    More Differentials

  • Guidelines

    • Position statement for clinical practice: prolactin-secreting tumors
    • ACR appropriateness criteria: neuroendocrine imaging
    More Guidelines
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