A microadenoma (tumor size: < 1 cm) is often clinically asymptomatic and occasionally presents with symptoms of hyperprolactinemia. The following symptoms and complaints may indicate hyperprolactinemia:
Symptoms in women
- Galactorrhea (abnormal breast milk discharge; seen in approximately 25-40% of women with hyperprolactinemia).
- Secondary hypogonadism/gonadal hypofunction (estrogen deficiency).
- Arrhythmias
- Amenorrhea – no menstrual bleeding until age 15 (primary amenorrhea) or no menstrual bleeding for > 90 days (secondary amenorrhea) [anovulation].
- Oligomenorrhea – the interval between bleeding is > 35 days and < 90 days, ie, bleeding occurs too infrequently [corpus luteum insufficiency(/luteal weakness; possibly anovulation/absence of menstrual bleeding for more than three months].
- Decreased libido
- Sterility (corpus luteum insufficiency/yellow body weakness; approximately 20% of all women with infertility have hyperprolactinemia).
- Osteoporosis
- Atrophy (tissue loss) of the vaginal epithelium (vaginal epithelium) (possibly dyspareunia / pain during intercourse).
- Arrhythmias
- Acne
- Hirsutism
Symptoms in men
- Galactorrhea (very rare)
- Secondary hypogonadism/gonadal hypofunction (testosterone deficiency).
- Impotence (erectile dysfunction (ED), erectile dysfunction).
- Infertility (infertility)
- Loss of libido
- Oligospermia (< 15 million sperm/semen cells per ml of ejaculate; see under spermiogram).
- Decreased beard growth
- Reduced muscle mass
- Osteopenia (reduction in bone density) or osteoporosis (bone loss) (in chronic and marked hyperprolactinemia),
Other symptoms
- Weight gain
- Possibly psychosyndrome (depression; anxiety, etc.)
A macroadenoma (tumor size: ≥ 1 cm) shows in particular displacement symptoms in addition to the symptoms of hyperprolactinemia.Macroadenomas are more common in men than in women. The following symptoms and complaints may indicate a prolactinoma:
Symptoms in women
- Amenorrhea – no menstrual bleeding until 15 years of age (primary amenorrhea) or no menstrual bleeding for > 90 days (secondary amenorrhea) [anovulation].
- Galactorrhea (milk flow) (- 80%).
- Cephalgia (headache)
- Infertility (infertility)
- Visual disturbances/facial field defects (bitemporal hemianopsia/visual disturbance with loss of both temporal visual fields; up to 45%) or other neurological symptoms (e.g., more severe headaches) and cranial nerve compression (in larger pituitary and near-pituitary tumors)
- Nausea (nausea)/vomiting.
Symptoms in men
- Impotence (erectile dysfunction (ED), erectile dysfunction).
- Infertility (inability to conceive).
- Loss of libido
- Galactorrhea (milk flow) and gynecomastia (enlargement of the mammary glands) (very rare).
- Cephalgia (headache)
- Visual disturbances/facial field defects (bitemporal hemianopsia/visual disturbance with loss of both temporal visual fields) or other neurological symptoms (e.g., headache) and cranial nerve compression
- Nausea (vomiting)/vomiting.
Signs or symptoms of anterior pituitary insufficiency (HVL insufficiency; hypopituitarism) (35% of cases).
- Abdominal – in the abdomen – fat deposits.
- Adynamia (general exhaustion or a marked lack of strength and drive).
- Arterial hypotension – low blood pressure.
- Paleness
- Bradycardia – too slow heartbeat: < 60 beats per minute.
- Depression
- Weight loss
- Hypoglycemia (low blood sugar)
- Cold intolerance (cold intolerance)
- Fatigue
- Osteoporosis (bone loss)
- Waning of the secondary hair
- Dwarfism