ARE YOU PROLACTINOMA?
Someone hears the word “Prolactinoma” and first thought “what is that?” Prolactinoma is a noncancerous tumor in the pituitary gland causing an overproduction of hormone called prolactin. It’s one of the more common types of tumors that can affect vision, infertility, decreased sexual interest, or stop menstruation while breast feeding. (Mayo Clinic Staff, 2015). Once the patient has stopped breastfeeding, the prolactin levels will go back to normal along with the menstrual cycle. Besides lowering the male’s sex drive, prolactinoma can enlarge breast tissue or produce milk (Pituitary.ucla.edu, 2017).
SIGNS AND SYMPTOMS
The patient may not notice any symptoms due to prolactinoma until the tumor has grown causing pressure or there is excessive prolactin in the blood. One of the first symptoms the patient will notice is a decrease interest or level of sexual interest. When a large tumor surfaces, it can cause loss of outer peripheral vision meaning the person can only see what they are focusing on, dull colors, or blurred vision (Pituitary.ucla.edu, 2017). In males, prolactinoma presents as erectile dysfunction or noticeably less body and facial hair. Females will notice symptoms sooner than males because of the irregular or missed menstrual, whereas men wouldn’t notice an issue until the tumor has grown (Mayo Clinic Staff, 2015).
At the initial visit with the physician, the doctor will ask about the patient’s medical history and symptoms while doing a physical examination. If the physician feels the patient presents with enough evidence, a hormone test and sometimes imaging will be required for further examination to determine a diagnosis. The hormone test, simple blood work is enough (Pituitary.ucla.edu, 2017). Prolactinomas can be due to a genetic predisposition and often come back. But overall, treatment is successful (Robert Ferry Jr. 2017).
The first visit will be with the patient’s family physician and then being referred to an endocrinologist for a definitive diagnosis. For testing and diagnosis reasons it’s important to inform the physician of all medications currently taking because some can elevate prolactin levels. An oral medication such as dopamine agonists is the most common form of treatment to shrink tumor size, reduce headaches and/or vision problems (Mayo Clinic Staff, 2015). When oral medication doesn’t help the physician will try surgery to remove the tumor or radiation therapy (Pituitary.ucla.edu, 2017). Dopamine agonists are divided into two categories: ergot and non-ergot. Agonists reduce “cell volume through inhibition of hormone secretion in an early phase; second, via gene transcription and prolactin synthesis at a later stage; and finally, by inducing perivascular fibrosis and cell necrosis” (Virtual library, 2017)
In conclusion, the cause for prolactinoma can be genetics and develop in the pituitary gland which helps to regulate growth hormone, blood pressure, and sexual interest. Most often presenting in women between 20 and 34 years old but can surface in any age or gender (Mayo Clinic Staff, 2015). Treatment has shown to be very effective by oral medication, radiation, or surgery. Women will often notice symptoms before men because of abnormal lactation from the breasts. At this time, there is no preventative medicine for prolactinoma. Once symptoms are noticed it’s important to see the physician as soon as possible.
Go.galegroup.com. (2017). Medical treatment of prolactinomas. Available at: http://go.galegroup.com/ps/retrieve.do?tabID=T002&resultListType=RESULT_LIST&searchResultsType=SingleTab&searchType=BasicSearchForm¤tPosition=5&docId=GALE%7CA254971545&docType=Clinical+report&sort=Relevance&contentSegment=&prodId=AONE&contentSet=GALE%7CA254971545&searchId=R1&userGroupName=ross_elyria&inPS=true [Accessed 13 Mar. 2017].
Pituitary.ucla.edu. (2017). Prolactinoma | UCLA Pituitary Tumor Program. Available at: http://pituitary.ucla.edu/prolactinoma [Accessed 11 Mar. 2017].
Robert Ferry Jr., M. (2017). Prolactinoma (Pituitary Tumor): Symptoms, Treatment, Surgery. MedicineNet. Available at: http://www.medicinenet.com/prolactinoma/article.htm [Accessed 14 Mar. 2017].
Staff, M. C. (2015). Prolactinoma definition. Mayoclinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/prolactinoma/basics/definition/con-20028094
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