Prolactinoma: Causes, Symptoms, and Medication Management

When your body makes too much prolactin, a hormone that triggers breast milk production and affects reproductive health. Also known as hyperprolactinemia, it often comes from a small, noncancerous tumor in the pituitary gland called a prolactinoma, a type of benign pituitary tumor that overproduces prolactin. This isn’t just about milk production—it disrupts sex hormones, fertility, and even bone density.

Prolactinoma affects women more often than men, but both can have it. In women, it might mean missed periods, unexpected breast milk, or trouble getting pregnant. In men, it can lead to low libido, erectile dysfunction, or reduced body hair. Some people have headaches or vision problems if the tumor presses on nearby nerves. The good news? Most prolactinomas are small and respond well to medication. Dopamine agonists, drugs like cabergoline and bromocriptine that mimic dopamine to lower prolactin and shrink the tumor are the first-line treatment. They work for most people, often eliminating symptoms within weeks. Surgery or radiation is rare and usually only needed if meds don’t work or the tumor is unusually large.

What you won’t find in most doctor’s offices is how often prolactinoma gets missed. Many assume symptoms like fatigue, low mood, or sexual issues are stress-related or aging. But if you’ve had unexplained hormonal changes for months, it’s worth asking for a blood test. Prolactin levels above 200 ng/mL almost always mean a tumor. Levels between 30 and 200 could be from meds, thyroid problems, or kidney issues—so context matters. You also need to know that some antidepressants, antipsychotics, and even certain herbs can raise prolactin. If you’re on any of those and have symptoms, talk to your doctor before making changes.

The connection between prolactinoma and other health issues is deeper than you think. High prolactin can lead to osteoporosis over time because it lowers estrogen and testosterone. That’s why bone density scans are often part of long-term care. And while most prolactinomas don’t grow back after treatment, regular follow-ups with blood tests and MRIs are standard. You’re not just treating a tumor—you’re protecting your whole hormonal system.

Below, you’ll find real-world advice on how prolactinoma interacts with other medications, what to watch for when starting treatment, and how to spot when something’s off. Whether you’re newly diagnosed, managing long-term, or just trying to understand unexplained symptoms, these posts give you the practical details doctors don’t always have time to explain.