Are there any changes in your body's hormones? Let's be aware of Prolactinoma (Prolactinoma)

Has your menstrual cycle suddenly become irregular? Or is there a milky white discharge from your breasts, even if you are not pregnant or breastfeeding? If you are a man, have you experienced a decrease in sexual interest or other problematic conditions? The reason for these things may be something you have never thought of. Today we are talking about such a condition, that is, a disease called Prolactinoma.

Simply put, what is Prolactinoma?

Prolactinoma is a tumor that develops in a small gland located very close to our brain, at the base of the brain, called the pituitary gland. Now, don't be afraid when we say "tumor." This is a non-cancerous (benign) tumor. That means it is not a life-threatening tumor that spreads throughout the body like cancer. This is the most common type of tumor that develops in the pituitary gland.

This tumor causes our body to produce more of a hormone called prolactin than it should. Normally, this prolactin hormone is mainly important for women's breast development and the production of milk for breastfeeding (lactation). But when this hormone increases, a condition called hyperprolactinemia occurs, it can cause various problems for both women and men.

Are there types of Prolactinoma?

Yes, these nuts are divided into two main types based on their size. To understand this, see the table below.

What are the symptoms of this?

The symptoms depend on the amount of prolactin hormone produced and the size of the tumor. Let's see what these symptoms are.

Women are more likely to recognize the condition early because of symptoms such as changes in their menstrual cycle or breast discharge. However, people who take birth control pills or other hormone treatments may not experience these symptoms. Also, symptoms may be delayed in women and men who have gone through menopause, which can delay diagnosis.

What is the reason for this?

In fact, researchers have not yet found a specific cause for Prolactinoma. Most of the time, it occurs sporadically, without any specific cause. However, some genetic conditions may increase the risk.

• ``Multiple endocrine neoplasia (MEN) type 1''
• `MEN type 4`
• ``Familial isolated pituitary adenomas (FIPA)''

How do you find this, Doctor?

Your doctor will first take a careful look at your symptoms and medical history. Then, they will perform a physical exam. They may then recommend several tests to confirm the diagnosis.

• Prolactin blood test: This is the most basic test. If this test confirms that your prolactin levels are much higher than normal, you will be referred for further tests to check for a tumor.
• MRI or CT scan: These scans can show exactly whether a pituitary tumor is present and, if so, how large it is. Doctors most often recommend an MRI scan.
• Testosterone level blood test: If you are a man, your doctor may also recommend testing your testosterone hormone levels.

If the disease is confirmed, it may be recommended to check the levels of other hormones in the pituitary gland and have an eye exam by an ophthalmologist to see if your vision is affected if you have a large tumor (macroprolactinoma).

What are the treatments for this?

The good news is that there are very effective treatments for this. In most cases, the condition can be controlled with medication.

Medicines (drugs)

Doctors often prescribe medications called dopamine agonists. These medications can shrink the prolactinoma and bring prolactin levels back to normal.

• Cabergoline and Bromocriptine: These are the two main drugs used. Of these, cabergoline is the first choice of doctors because it is more effective and has fewer side effects.
• Side effects: These medications may cause minor side effects such as nausea, vomiting, and dizziness.
• Duration of treatment: To prevent the tumor from coming back, you will need to take this medication continuously for at least two years . After two years, if your prolactin levels have returned to normal and the tumor is no longer visible on scans, your doctor will gradually reduce the dose of the medication and eventually stop it.

Surgery

Surgery is rarely necessary. This is in cases like these:

• If the medication has serious side effects.
• If the tumor does not shrink with medication.
• If this medicine reacts with other medicines you are taking.
• If you have a large tumor and need to have it removed before trying to get pregnant.

There are two types of surgery.

1. Transsphenoidal surgery: This is the most common surgery. Here, the tumor is removed through a small incision inside the nose or under the upper lip.

2. Transcranial surgery: If the tumor is very large, the tumor is removed through a small opening in the skull.

Radiation therapy

Radiation therapy is a third option when the cancer does not respond to medication or surgery. This is also a very rare treatment.

What is the outlook for this disease?

The outlook for prolactinoma is very good. With medical treatment, 4 out of 5 people with small tumors can have their prolactin levels normalized and the tumor can shrink.

Surgery is also often successful. When performed by an experienced surgeon, prolactin levels can be restored to normal in about 90% of people with small tumors and 50% of people with large tumors.

prolactinoma sinhala, prolactinoma kiyanne mokakda, prolactinoma lakshana, pituitary gland gediyak, hormone asamanathawaya, osap akramawath weema, pirimi mada bawa