Which clinical history findings are characteristic of prolactinomas in women?

Updated: Mar 25, 2018
  • Author: Venkatesh Babu Segu, MD, MBBS, DM; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Prolactinomas can cause symptoms secondary to the hormonal effects of excess PRL and to the space-occupying effects of the tumor itself.

The clinical features of sustained hyperprolactinemia (which vary with the duration and degree of the condition, as well as with the age and sex of the patient) are as follows [7, 10] :

  • Reproductive-aged females can present with menstrual disturbance and/or infertility. [18] The usual menstrual aberration in these women is oligomenorrhea, amenorrhea, or the occurrence of irregular menstrual cycles. Occasionally, if the prolactinoma occurs in a person of younger age, delayed menarche can result.

  • Galactorrhea can be spontaneous or expressive (only upon squeezing of the nipples). Galactorrhea is observed in 30-80% of these women and can be quite distressing for the patient.

  • Other features of hypoestrogenism include vaginal dryness, dyspareunia, and a decline in bone mineral density (ie, osteopenia or osteoporosis). [9]


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