Treatment:

Not everyone needs treatment for prolactinoma.

Medication is usually successful in treating prolactinoma. Surgery is done in some cases where the tumor may damage vision.

In women, treatment can improve:

• Infertility
• Irregular menstruation
• Loss of sexual interest
• Milk flow not related to childbirth or nursing

Men should be treated when they have:

• Decreased sexual drive
• Impotence
• Infertility

Large prolactinomas generally must be treated to prevent vision loss.

Bromocriptine and cabergoline are drugs that reduce prolactin levels in both men and women. They usually must be taken for life. If the drug is stopped, the tumor may grow and produce prolactin again, especially if it is a large tumor. Most people respond well to these drugs, although large prolactinomas are more difficult to treat. Both drugs may cause dizziness and upset stomach.

Using bromocriptine over time can reduce the chance of being cured by removing the tumor. Therefore, if surgery is needed, it is best to remove the tumor during the first 6 months of using this drug.

Radiotherapy with conventional radiation or gamma knife is usually reserved for patients with prolactinoma that continues or gets worse after both medication and surgery.

Expectations (prognosis):

The outlook depends greatly on the success of medical therapy or surgery. Tests to check for recurrence of the tumor following treatment are important.

Complications:

• Bleeding
• Tumor regrowth

If untreated, a growing tumor can press on the optic nerves and cause:

• Blindness
• Double vision
• Permanent vision loss

Calling your health care provider:

See your health care provider if you have any symptoms of prolactinoma.

If you have had a prolactinoma in the past, call your health care provider if the symptoms return.