Prolactinoma: what it is and why it matters

Prolactinoma is a small benign tumor on the pituitary gland that makes too much prolactin. High prolactin can stop periods, cause unexpected milk production, lower sex drive, and affect fertility. Some people have headaches or blurry vision if the tumor presses nearby structures. The good news: most prolactinomas respond well to medicine and regular monitoring.

Symptoms & how it’s diagnosed

Symptoms vary by sex and tumor size. In women you may notice missed or irregular periods, infertility, or milky nipple discharge. In men common signs are low libido, erectile problems, or unexplained tiredness. Larger tumors can push on the optic nerves and cause visual field loss—often a widened blind spot or missing side vision.

Diagnosis is straightforward. Your doctor will order a blood test for prolactin and likely a pregnancy test if applicable. If prolactin is high, they check thyroid hormone and review medications that raise prolactin (some antipsychotics, metoclopramide, certain antidepressants). An MRI of the pituitary confirms the tumor and its size.

Treatment options & everyday tips

Dopamine agonist pills are the first choice. Cabergoline and bromocriptine lower prolactin and usually shrink the tumor. Cabergoline is taken twice weekly or less and often has fewer side effects than bromocriptine. Common side effects include nausea, dizziness, and tiredness—these often ease in a few days. Your doctor will check heart health and prolactin levels over time.

Surgery is needed if medicine doesn’t work or if the tumor causes urgent vision problems. Radiation is rarely used but can help when other treatments fail. If you’re trying to get pregnant, talk to your endocrinologist—many stop the drug during pregnancy under close follow-up, but plans vary by case and tumor size.

Practical things you can do: keep a list of all your medicines (some raise prolactin), track menstrual cycles and libido changes, and report any new headaches or vision changes right away. Schedule follow-up blood tests and MRIs as your doctor recommends. If you plan pregnancy or fertility treatment, get specialist guidance—treatment choices and timing matter.

When to seek urgent care: sudden vision loss, severe persistent headache, or fainting. These could mean the tumor is pressing on nearby tissue and need immediate attention.

Managing a prolactinoma usually means steady monitoring and good communication with your endocrinologist. Most people regain normal hormone levels and fertility with treatment. If you have questions about drug options, side effects, or how treatment affects pregnancy, bring them up at your next visit—clear answers make decisions easier.