Prolactinoma

Definition - What does Prolactinoma mean?

Prolactinomas are benign (non-cancerous) brain tumors that cause an increase production of the hormone prolactin. In women trying to conceive, high prolactin levels are associated with menstrual irregularities or the complete cessation of ovulation. Some women might also notice the production of breast milk known as galactorrhea.

In men, increased levels of prolactin lead to decreased testosterone levels characterized by low sexual libido, erectile dysfunction, and reduction in both testicular size and activity.

FertilitySmarts explains Prolactinoma

Prolactin is a hormone produced by the pituitary gland located in the brain. The primary function of this hormone is increasing the female breast size during pregnancy in preparation for breastfeeding and stimulating the release of breast milk postpartum; blood levels tend to stay elevated until breastfeeding is stopped.

Hormones within the body tend to act as “on/off switches” for other hormones and elevated prolactin hormone, known as hyperprolactinemia, decreases the level of important fertility-related hormones such as follicle-stimulating hormone, that is responsible for sperm and egg production and the sex hormones, testosterone, and estrogen in both males and females respectively.

Low estrogen levels lead to menstrual irregularities and often women have no periods at all, a state known as amenorrhea. In men, low testosterone leads to infertility and sexual dysfunction.

Treatment for prolactinomas is dependent on many factors such as the size of the tumor and the current health status of the patient. For example, for men and women trying to get pregnant, treatment for smaller tumors include the drug bromocriptine, a medicine that acts like the hormone dopamine.

The hormone dopamine naturally acts as an "off switch" for prolactin, so taking increased amounts of dopamine in the form of bromocriptine will naturally decrease the production of prolactin, and in many accounts reduce the size of the tumor.

In pregnancy, bromocriptine is stopped due to the lack of knowledge on possible effects on the fetus but pregnant women who develop tumor-related complications such as rapidly growing tumors, headaches or vision troubles tend to be put back on the drug but with very close monitoring.

For people with very large tumors, especially those causing size related side effects such as headaches or vision changes, doctors might suggest surgery to manually reduce the size and if the position of the tumor is too dangerous for surgery, radiation might also be tried.

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