Prolactinoma - Complications and Prognosis

What are the complications and outlook for prolactinomas?

What are the possible complications?

The main complication is the risk of 'thinning' of the bones (osteoporosis), which occurs if high prolactin levels are untreated for a long time (over one year). Osteoporosis can be prevented by treating the prolactinoma (as above). Alternatively, replacement oestrogen or testosterone can be taken.

Large prolactinomas may cause complications if they grow and press on the structures nearby: the pituitary gland, the brain and the nerves to the eye. If untreated, the pressure might eventually lead to loss of vision, other hormone problems (which could cause severe illness) or severe headaches.

Rare complications are:

  • A leak of fluid from around the brain into the nose, which causes a risk of infection such as meningitis.
  • Pituitary apoplexy, which is rare but very serious. There is a bleed inside the tumour, making it suddenly expand. This causes sudden increasing symptoms such as headache and reduced vision, and may cause collapse. It needs urgent treatment and may require surgery.

What is the outlook?

The outlook (prognosis) for most people with a prolactinoma is very good. Most prolactinomas are successfully treated with medication. If this does not work, surgery is usually successful. 

Treatment for women can restore periods and fertility (assuming that the fertility problem was due to the prolactinoma). Fertility for men can also improve with treatment.

For some people, the prolactinoma may be cured after about three years of taking medication. So you may be able to come off treatment.

Prolactinomas can come back, even after successful treatment with medication or surgery. You will still need monitoring (such as regular blood tests) to check that the prolactinoma has not come back. If it has, then treatment can be restarted.

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Author:
Dr Colin Tidy
Peer Reviewer:
Dr John Cox
Document ID:
8710 (v5)
Last Checked:
12 May 2017
Next Review:
29 June 2020

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.