Prolactinomas
Our prolactinomas specialists in New York are here for you. Our team of endocrine doctors near you are dedicated to supporting your success and ensuring that you regain your metabolic health and overall wellness.
What Are Prolactinomas?
Prolactinomas are a type of pituitary adenoma, which are benign tumors that originate in the pituitary gland. Prolactinomas are characterized by the excessive production and secretion of the hormone prolactin. Prolactin is a hormone primarily involved in the regulation of breast milk production and reproductive function. Prolactinomas can be classified by size into microadenomas (<10 mm) and macroadenomas (≥10 mm). The hypersecretion of prolactin leads to various endocrine and reproductive disturbances due to its inhibitory effect on gonadotropin-releasing hormone (GnRH), resulting in decreased secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This hormonal imbalance can cause hypogonadism, infertility, and galactorrhea. In women, this often manifests as oligomenorrhea or amenorrhea, while men may experience decreased libido and erectile dysfunction.
What Are the Causes of Prolactinomas?
The exact cause of prolactinomas is not fully understood, but they are believed to be the result of genetic and environmental factors. The etiology of prolactinomas primarily involves genetic mutations and dysregulation within the pituitary gland. Genetic predispositions, such as mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene, are implicated in some cases, particularly in familial isolated pituitary adenomas (FIPA). Somatic mutations in the prolactin-secreting cells may lead to autonomous cell growth and prolactin overproduction. Additionally, disruptions in hypothalamic regulation, including decreased dopaminergic inhibition or altered expression of dopamine receptors on lactotroph cells, can contribute to the pathogenesis of prolactinomas. Estrogen exposure, which stimulates prolactin synthesis and lactotroph proliferation, is another factor that may influence tumor development, particularly in women. Furthermore, the loss of normal pituitary feedback mechanisms, possibly due to other pituitary or hypothalamic lesions, can result in unregulated prolactin secretion. Finally, environmental and epigenetic factors may also play roles in the onset and progression of prolactinomas through complex gene-environment interactions.
The symptoms of prolactinomas can vary depending on the size of the tumor and the degree of prolactin excess, and may include:
Irregular or absent menstrual periods in women
Infertility
Breast milk production in non-breastfeeding individuals (galactorrhea)
Sexual dysfunction
Headaches
Vision problems
Prolactinomas are typically diagnosed through a combination of:
Blood tests to measure prolactin levels
Imaging studies, such as MRI or CT scans, to visualize the pituitary gland and any tumors
What Are the Treatments and Therapies for Prolactinomas?
The primary treatment for prolactinomas is medication, typically dopamine agonists, such as cabergoline or bromocriptine, which can help lower prolactin levels and reduce tumor size.
In some cases, surgery or radiation therapy may be necessary, particularly if the tumor is large or if medication is not effective.
How Can Well by Messer Help You with Prolactinomas?
At Well by Messer, our endocrinologists are highly skilled at diagnosing and treating prolactinomas. Close follow up with frequent blood testing, especially at the start of treatment, is necessary in order to achieve normal prolactin levels. At WBM, we conduct all blood testing on site and our providers can review the results and make any medication changes right away. In addition, our providers follow up with patients regularly to ensure that symptoms are resolved with adequate treatment.
Meet the Well by Messer (WBM) Team
Under the leadership of top endocrinologist in New York, Dr. Caroline Messer, our caring and talented team of board-certified endocrinologists, psychologists, nutritionists, and personal trainers will be dedicated to supporting your success and regaining your metabolic health at our metabolic centers in Manhattan.
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