If you’re a woman of child bearing age and your periods stop, you’re likely to be a little concerned. If you have ruled out pregnancy, extreme exercise and extreme stress as possible causes, you’re probably getting quite worried. Now it might be worth considering if you have a prolactinoma.
What Is A Prolactinoma?
A prolactinoma is a benign tumor (called an adenoma) on the pituitary gland. It causes excess production of prolactin (hyperprolactinemia), a hormone that is designed to stimulate the production of breast milk. In most people these tumors are small and many people don’t even realize they have one, but occasionally one grows bigger and presses on the optic nerves or other surrounding tissue.
Symptoms Of Prolactinoma
Men and women can both suffer from prolactinomas. In women of childbearing age, symptoms include the following
Absence of menstrual periods in some women (amenorrhea)
Menstrual irregularities (oligomenorrhea)
Discharge from the breasts when not pregnant or breastfeeding (galactorrhea)
Vaginal drynessleading to painful intercourse
Acne and excess facial and body hair
The symptoms of prolactinoma are less obvious for men; many men don’t realize they have a problem at first. They indude:
-Loss of libido
-Loss of body or facial hair
-Enlarged or tender breasts (gynecomastia)
Both sexes can experience symptoms due to the disruption in the production of other hormones or the tumor growing large enough to press on surrounding tissue. These symptoms include:
-Loss of libido
-Low bone density
Hormonal imbalances due to the reduced or altered production of other hormones
Women tend to be diagnosed with prolactinoma much earlier than men do due to their more obvious symptoms. Diagnosis usually begins with a blood test to check for prolactin levels. If prolactin levels are elevated the doctor is likely to order a brain scan; the most common type is an MRI (Magnetic Resonance Image).
If an M RI shows a tumor the patient will be referred to an endocrinologist for treatment. Some tumors are too small to be seen on an MRI; these are called micro prolactinomas In this case, it is still likely that an endocrinologist will continue the treatment to manage the symptoms.
Depending on the size of the tumor there are several options for treatment. If the endocrinologist believes that the tumor is growing (progressing from a micro prolactinoma to a macroprolactinoma) he or she may opt to prescribe a dopamine agonist drug and monitor the tumor. If the tumor is already big enough to cause other problems such as visual disturbances, surgical removal is likely to be the best option. In most cases, however, a dopamine agonist is sufficient to control the tumor and may even shrink it. Treatment is usually a long-term proposition and patients can expect to be taking the drug for two or more years.
What Does A Dopamine Agonist Do?
Dopamine inhibits the production of prolactin. However, when a prolactinoma is present, the body is unable to secrete sufficient dopamine to keep prolactin levels under control. Dopamine agonist drugs such as bromocriptine or cabergoline work by stimulating dopamine receptors, increasing their capacity to collect dopamine. The effect is that dopamine activity increases In the case of prolactinomas, it is usually sufficient to keep prolactin under control.
What To Do If You Think You Might Have A Prolactinoma
The best thing to do is get a diagnosis sooner rather than later. If you have a tumor and it’s growing, treatment should not be delayed. Surgery to remove a tumor is seen as a last resort and if you start treatment early enough you may be able to avoid it entirely. But don’t worry: in the majority of cases, taking the drug is sufficient.
A prolactinoma is something that most people are able to live with quite easily. Some even find that it goes away after a while and they are back to normal. 50 if you have been diagnosed with one or suspect you might have one, relax Chances are you will be fine.