The pituitary gland serves many functions in the human body through the release of hormones, and pituitary tumors, or pituitary adenomas, can disrupt these functions. Pituitary adenomas are small tumors that are generally benign. Found in approximately 20 percent of adults, most never cause a problem for the patient. For some, however, it can affect the balance of hormones in your body and may cause symptoms such as gigantism, Cushing’s disease or infertility.
What are Prolactinomas?
Prolactinomas are pituitary adenomas that occur in the pituitary gland and produce excess amounts of prolactin. This type of pituitary adenoma makes up approximately 30 percent of reported cases and can cause hyperprolactinemia- potentially resulting in a negative impact to your libido, menstrual cycle and fertility.
Hyperprolactinemia and Infertility
The hormone prolactin is naturally highest in breastfeeding women, as it causes the mammary glands to enlarge and assists with the release of milk. Prolactin also inhibits ovulation. Women suffering from hyperprolactinemia may experience breast discharge, missed periods or no menstrual cycle, also known as amenorrhea.
In mild cases of hyperprolactinemia, you may not experience problems with ovulation. However, progesterone production post-ovulation could be reduced. In these cases, the uterine lining may not thicken enough to support implantation. Talk with your fertility doctor about all symptoms you may be experiencing to determine if you could be experiencing hyperprolactinemia.
If hyperprolactinemia is suspected, your fertility doctor will begin by checking your hormone levels, including your prolactin levels. If your prolactin levels are high, it is possible you have a prolactinoma. However, some medications can cause increased prolactin levels, so your fertility doctor will need to determine if you are taking any medication that could contributing to abnormally high prolactin levels. In the event a pituitary adenoma is suspected, your fertility doctor may recommend consulting with an endocrinologist.
Treating hyperprolactinemia caused by a prolactinoma is most commonly done through oral medication. In over 90 percent of patients, oral treatment can reduce the size of the tumor and normalize prolactin levels. Some cases, approximately 10 percent, may require surgical intervention or radiation therapy to remove or shrink the tumor.
Though recurrence rates are low, you may require follow-up visits, blood tests and MRIs to monitor your progress and ensure the tumor does not return. Speak with your fertility doctor to identify your options.