Signs and Symptoms

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Premenopausal women:

Headache and compromised or loss of vision caused by the prolactin-secreting tumor and its close proximity to the optic structures.

• Clinical presentation is associated with the degree of prolactin elevation:

• Prolactin greater than 100 ng/mL (100 mcg/L): hypogonadism, galactorrhea, and amenorrhea

• Prolactin 51 to 75 ng/mL (51-75 mcg/L): oligomenorrhea (infrequent menstruation).

• Prolactin 31 to 50 ng/mL (31-50 mcg/L): decreased libido and infertility.

• Increased body weight may be associated with prolactin-secreting pituitary tumor.

• The degree of hypogonadism generally is proportionate to the degree of prolactin elevation.

• Excessive hair growth (hirsutism) and acne also may be present owing to relative androgen excess compared with low estrogen levels.

Men:

• Decreased libido, decreased energy, erectile dysfunction, impotence, decreased sperm production, infertility, gynecomastia, and rarely, galactorrhea.

• Impotence is unresponsive to treatment and is associated with reduced muscle mass, loss of pubic hair, and osteoporosis.

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