Symptoms of prolactinoma are caused by hyperprolactinemia or by pressure of the tumor on surrounding tissues.
Symptoms in women and men
In women, hyperprolactinemia often cause changes in menstruation and infertility.
Some women may lose periods altogether (amenorrhea), and others may have irregular or infrequent menstruation.
Women who are not pregnant or nursing may begin producing breast milk (called galactorrhea). Some women may experience a loss of libido (interest in sex).
Patients with large pituitary tumors (macroadenomas, greater than 10 mm) may also have low levels of the other pituitary hormones (called hypopituitarism) because of pressure of the tumor on the normal gland. Therefore, it is important for the physician to measure the other pituitary hormones as well. Macroadenomas, if compressing the optic nerves, could cause loss of peripheral vision as well.
Women with hyperprolactinemia and amenorrhea may have an increased risk for osteoporosis (bone loss). In amenorrhea, the ovaries are producing inadequate amounts of estrogen, which increases the risk for osteoporosis. It is important for women with a history of amenorrhea to have bone density measurements performed, even after hyperprolactinemia treatment, to assess the effect of the estrogen deficiency on bone.
In men, the most common symptoms of prolactinoma are impotence and diminished libido.
Pressure of the tumor on surrounding tissues may lead to headaches or eye problems caused by the enlarged pituitary pressing against nearby eye nerves.
Patients with macroadenomas may also have hypopituitarism because of pressure of the tumor on the normal gland. Therefore, it is important to measure the other pituitary hormones as well.