In general, macroadenomas produce more prolactin than smaller tumors, although up to 15 percent of macroadenomas may produce only small amounts of prolactin. Symptoms that occur with prolactin-secreting adenomas include amenorrhea and galactorrhea in women, and decreased libido and erectile dysfunction in men. With rapidly enlarging macroadenomas, visual field defects or headaches Growth hormone-secreting adenomas account for about 15 percent of all clinically diagnosed pituitary adenomas. In adults, overproduction of growth hormone results in acromegaly because the growth plates are closed. Symptoms and physical features of acromegaly include large hands and feet, forehead bossing, fatigue, parotid gland enlargement, decreased libido and erectile dysfunction, paresthesias and nerve entrapment syndromes, and Treatment.
Surgery is the treatment of choice when the tumor is large and the symptoms are significant.
Evidence that the tumor is causing local, invasive compression of nearby structures or is in an eccentric location that could compromise carotid sinuses is an indication for surgery. The dose may be increased until an acceptable clinical response is Bromocriptine side effects include nausea, flushing, headache, hypotension, nasal congestion, and hallucinations. Within six months after starting dopaminergic therapy, about 80 percent of women resume normal ovulation. Women wishing to nurse should discontinue bromocriptine. Dopaminergic agents are also used to suppress growth hormone.