Causes and risk factors
The exact cause of the prolactinomas is not known however stress is said to be the major causation. Prevalence of prolactinomas is also seen in individuals due to certain medication which are used for treatment of thyroid or mental illness.
Clinical presentation
Prolactinomas are of two types, macroprolactinoma (where the size of the tumor is more than 10mm diameter) and microprolactinoma( when the size of the tumor is less than 10mm diameter).As compared to macrotumors, microtumors are more common.Excess of prolactin leads to altered production of estrogen and testosterone. In females prolactin stimulates the mammary gland to produce milk, during pregnancy it causes enlargement of the breasts. In both males and females it is responsible for sexual satisfaction.High levels of prolactin thus cause suppression of sex hormones giving rise to symptoms like libido, infertility, headache, changes in vision. It leads to gyncomastia in males. Breast tenderness and early menopause occurs in females. Lethargy, changes on olfaction and nausea along with vomiting are the other associated symptoms seen. The tumor can lead to complications in pregnancy; it can alter the other hormonal levels and can also lead to blindness.
Investigations
Diagnosis is done on the basis of symptoms narrated by the patient and the examination carried out by the doctor. Certain investigations are advised for confirmation. Hormonal tests for prolactin, estrogen and testosterone levels are tested. Thyroid function test can also be advised. If required MRI of the brain is recommended. Certain other sets of routine investigations can also be advised.
Treatment
The treatment aims at reducing the size of the tumor, and normalizing the prolactin levels and to treat the other associated complaints. Administration of a dopamine agonist is the first line of treatment. . If medicational approach does not help out then surgery is opted. Transcranial of transphenoidal surgery is done for excision of the tumor. Radiation therapy is also another line of treatment.
Other modes of treatment:
The other modes of treatment can also be effective in treating prolactinomas. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms
