Prolactinoma: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Prolactinoma?
An endocrinologist (a doctor who treats hormone problems) usually leads care for prolactinoma. A neurosurgeon (a brain and pituitary surgeon) may help if surgery is needed. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is prolactinoma?
A prolactinoma is a noncancerous tumor of the pituitary gland. The tumor makes a hormone called prolactin. The pituitary is a pea-sized gland at the base of the brain. It controls the production of many hormones. Prolactin is a hormone that triggers the breasts to produce milk. Too much prolactin in the blood is called hyperprolactinemia. It can cause infertility, which is trouble having a baby, and other problems. Prolactinoma is the most common type of pituitary tumor that makes a hormone.
Symptoms
Symptoms can be different in women and men.
In women, common symptoms include:
- Irregular periods or no periods.
- Trouble getting pregnant, called infertility.
- Milky discharge from the breasts when not pregnant or breastfeeding, called galactorrhea.
- Loss of interest in sex.
In men, common symptoms include:
- Loss of interest in sex linked to low levels of testosterone.
- Erectile dysfunction, which means trouble getting or keeping an erection.
A larger tumor may press against nearby parts of the brain. This can cause headaches and vision problems, including double vision and drooping eyelids. There may be no symptoms, especially in older men.
Causes and who gets it
Most pituitary tumors develop on their own, and the cause is unknown. In some cases, genetic factors may play a role.
Prolactinomas occur most commonly in people in their 20s and 30s. Women are more likely than men to develop a prolactinoma. Larger tumors are more common in men.
Prolactin levels normally rise during pregnancy and breastfeeding. Some antipsychotic medicines and some high blood pressure medicines can raise prolactin levels. So can medicines for nausea and vomiting and pain relievers that contain opioids. Follow your doctor's instructions before stopping any medicine.
How doctors diagnose it
A health care provider will do a physical exam and ask about your symptoms. You will also be asked about the medicines you take. A prolactin blood test measures the level of prolactin in your blood. If the level is too high, the doctor will order an imaging test to look for a tumor. A computed tomography (CT) scan may be used when an MRI is not an option. A vision test may be done, depending on the size of the tumor.
Treatment
The goals of treatment are to bring prolactin levels back to normal and shrink the tumor. Medicines called dopamine agonists control prolactin levels. They also shrink the tumor very well. Bromocriptine and cabergoline are the two most commonly used. Cabergoline is the preferred drug. It works better than bromocriptine and has fewer side effects. For most small prolactinomas, these medicines bring prolactin back to normal in 4 out of 5 patients. They also shrink the tumors.
Common side effects are nausea, vomiting, and dizziness. Rarely, people taking these medicines have had problems with impulse control, such as compulsive gambling. You may need these medicines for a long time. This helps stop the tumor from growing back. After 2 years, the medicines may be slowly lowered and stopped. This is only if prolactin is normal and the tumor can no longer be seen.
Surgery may be an option if the medicines are not tolerated or not working. Side effects of surgery can include low pituitary function and a leak of the fluid around the brain. Radiation is used more rarely, if medicines and surgery fail to reduce prolactin levels.
When to see a doctor
Contact your provider if you have any symptoms of prolactinoma. If you have had a prolactinoma before, contact your provider for a follow-up or if symptoms return. An untreated pituitary tumor can suddenly get bigger, often from bleeding. The risk is small. This is called pituitary apoplexy, and it is a medical emergency. Call 911 or go to the emergency room if you have the worst headache of your life. Also go if you have sudden vision loss, double vision, or confusion.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can review symptoms, order first blood tests, and help coordinate care with an endocrinologist.
Common questions
Is a prolactinoma cancer?
No, a prolactinoma is a noncancerous tumor.
Can medicine alone treat a prolactinoma?
Yes, in most cases medicine can treat it successfully.
Can a prolactinoma affect pregnancy?
Yes, it may make it harder to become pregnant. A prolactinoma may also grow during pregnancy, especially if it is already large. Once pregnancy is confirmed, your doctor will usually advise you to stop taking the medicine.
Do men get prolactinomas?
Yes, although women are more likely to get them. Larger tumors are more common in men.
Can I stop taking prolactinoma medicine?
Sometimes, after 2 years of treatment. This is possible if prolactin levels are normal and the tumor can no longer be seen. If your prolactin level goes back up, you may need to go back on the medicine. Follow your doctor's instructions and do not stop on your own.
Sources
- MedlinePlus - Prolactinoma
- National Institute of Diabetes and Digestive and Kidney Diseases - Prolactinoma
- MedlinePlus - Pituitary apoplexy
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
