endocrine and metabolic disorders
Prolactinoma
Symptoms and Signs of Prolactinoma
Abnormal lactation is not defined quantitatively; it is milk release that is inappropriate, persistent, or worrisome to the patient. Spontaneous lactation is more unusual than milk released in response to manual expression. The milk is white, and fat globules can be seen when a sample is examined with a microscope. Women with galactorrhea commonly also have amenorrhea or oligomenorrhea. Women with galactorrhea and amenorrhea may also have symptoms and signs ofestrogendeficiency, including dyspareunia and reduced libido, due to inhibition of pulsatile luteinizing hormone and follicle-stimulating hormone release by high prolactin levels. However,estrogenproduction may be normal, and signs of androgen excess, including hirsutism, have been observed in some women with hyperprolactinemia. Hyperprolactinemia may occur with other menstrual cycle disturbances besides amenorrhea, including infrequent ovulation and corpus luteum dysfunction. Men with prolactin-secreting pituitary tumors typically have headaches or visual difficulties. About two thirds of affected men have loss of libido and Erectile Dysfunction . 