Prolactinoma and pregnancy

Submitted by Shelby D Burns Tue 07/26/2011

The most common type of pituitary tumor is called a “prolactinoma”. It is a benign tumor of the pituitary gland that produces a hormone called prolactin. A prolactinoma will cause too much prolactin in the blood (hyperprolactinemia) or put pressure on surrounding tissues causing other types of problems. Prolactin has many functions. For non pregnant people, men and women, prolactin is highest when sleeping and during times when calm is desired, times of shock and distress. For women, prolactin levels are usually higher during pregnancy and after childbirth. It stimulates the production of breast milk. When breastfeeding stops, prolactin levels come down to normal. For all women, the pituitary enlarges and prolactin production increases during normal pregnancies. If a woman has a small prolactinoma, there is no reason that she cannot conceive and have a normal pregnancy after successful treatment. Because too much prolactin in the blood with interferes with fertility, many times a doctor will prescribe medication, bromocriptine or cabergoline, to level out the hormones. Once pregnancy is established the medications can stop unless problems persist. Even if the prolactinoma increases output of the hormone, a normally progressing pregnancy would as well, so as long as the secretion levels are monitored and treated as necessary, pregnancy should be manageable. In some women with larger tumors, there may be other risks. Damage to the pituitary or eye nerves is rare but possible. If a woman has previously had a successful pregnancy, the chances of her repeating the experience are extremely high. A woman who knows she has a prolactinoma needs to discuss her plans to conceive with her physician. It is likely an MRI will be done to assess the size of the tumor and the risk for hyperlactinemia. Careful evaluation will ensure a successful experience.

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