Prolactinoma; The Fall of a Young Male

Question #17151

65 days ago

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Prolactinoma; The Fall of a Young Male - #17151

Erkan Ak

Firstly,I am really out of solution right now as the doctors in Turkey don't know much about. God knows how many doctor's I went.I need your help. Sorry for novelty type of title. :) I was diagnosed prolactin secreting microadenoma, with the size of 2.5 mm, like 2 years ago.Ive had headaches heavily and my balls shrunk in volume with time (not testicles inside, as approved with USG by the urologist). The thing is it's been so hard that my libido went down zero, I started to have ED,fall of my hairs from all overthe Body...Anyway,I still couldn't find a cure for everythingI'vedone, used HCG+Gonal F to at least have a bit pump in my values. I can say a bit about the effects of this hell of an illness.My body gives me signals on what is the problem by which I can say; My body hairs, specifically inner legs, were so much hairy but after i cut it, it does not grow. My testicles and my nipples go change color throughout the day like white colour.I highly suspect those things are happening because of DHT and that's why I am reaching out to you respectful people to answer on this. Thanks in advance for everything you can contribute.

Age: 26

Chronic illnesses: None

Testicles

300 INR (~3.53 USD)

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

64 days ago

Hello dear
See as per clinical history it seems benign tumour of pituitary gland
As it is already showing loss of libido and infertility so you may require below treatment options
In addition to mri and CT scan
Get below tests also
Serum tsh
Lft
Rft
RBS
Serum ferritin
Following medication can be given
Bromocryotine
Caber goline
Last option is transpendoidal surgery
Kindly consult endocrinologist for further details
Regards

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

64 days ago

Hello,
You likely still have symptoms because the prolactin-secreting microadenoma is suppressing your testosterone and DHT levels, which explains your low libido, ED, reduced body hair growth, testicular changes, color changes in nipples/scrotum, and overall hormonal imbalance. Even though you’ve tried HCG and Gonal-F, they can only give partial relief because they don’t fix the real problem: high prolactin blocking your natural testosterone production.
The typical, effective treatment for this condition is a dopamine agonist like cabergoline, which lowers prolactin, restores testosterone/DHT levels, and often improves symptoms within weeks.
With the right treatment and updated labs (prolactin, testosterone, LH, FSH, estradiol, thyroid, and a follow-up MRI), your condition is very treatable and usually reversible,I think.
You can do a online video consultation with a Endocrinologist from India, (if less facilities there) for better clarity and treatment.
If you want i can suggest you the best hospitals in India.
I hope this helps
Thank you!

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

59 days ago

Hello Erkan Ak, thank you for sharing tour concern. You symptoms fit very well with a Prolactin Secreting Microadenoma.
There are some medicines which are proven to lower prolactin, shrink the tumor, restore testosterone libido erections, etc. Discuss about “Dopamine Agonists” with your doctor or a Neurologist.
HCG or Gonal-F will not fix the problem if Prolactin stays high.
Kindly get these tests done- Serum prolactin, Total + free testosterone, LH, FSH, Thyroid profile, MRI pituitary (6–12 month follow-up).
Immediately consult your treating doctor if - Vision changes, Persistent headaches, No response to dopamine agonists, Rising prolactin despite treatment.
Feel free to reach out again.
Regards,
Dr. Nirav Jain
MBBS, DNB D.Fam.Med

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

63 days ago

From your description, it sounds like you’re dealing with symptoms commonly associated with a prolactin-secreting microadenoma, known as a prolactinoma. This is a type of pituitary gland tumor that results in overproduction of the hormone prolactin. Elevated prolactin levels can cause reduced testosterone production, leading to symptoms like decreased libido, erectile dysfunction (ED), decreased body hair, and testicular changes. It’s important to address the underlining cause of these symptoms, which is the elevated prolactin level. In this case, treatment typically involves medications such as dopamine agonists like cabergoline or bromocriptine, which can help reduce prolactin levels and shrink the tumor over time. These medications can often reverse many of the symptoms you’re experiencing. It’s critical to work closely with an endocrinologist, a specialist in hormone-related disorders, who can manage and adjust your treatment based on regular monitoring of prolactin levels and other symptoms. Regarding your concerns about dihydrotestosterone (DHT), it’s less likely to be directly related to your condition unless you’re receiving specific treatments known to affect DHT pathways. Since you’ve noticed changes in body hair and skin tone, it’s essential to thoroughly discuss these symptoms with your specialist, as they may need to assess hormone levels comprehensively. If you’re not getting adequate support from your current healthcare providers, consider reaching out to medical centers or specialists with experience in treating pituitary disorders, even beyond your local area if needed. Finally, ensure that you’re maintaining regular follow-ups and MRI scans to monitor the adenoma’s size and any changes in your symptoms.

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

62 days ago

Your tumor is small (microadenoma), very safe.
Prolactinoma is not cancer.
Men with your condition return to normal sexual function after correct treatment.
Hair, libido, erections, even fertility usually recover completely.
You are NOT doomed, and this is absolutely fixable.

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

62 days ago

Hello Erkan
It sounds like you’re dealing with a complex situation related to your prolactin-secreting microadenoma and its effects on your body. The symptoms you describe, including headaches, reduced libido, erectile dysfunction, and changes in body hair, can indeed be linked to hormonal imbalances caused by the adenoma.
Here are a few points to consider:
- Prolactin Levels: Elevated prolactin can lead to symptoms like reduced libido and erectile dysfunction. Managing the prolactin levels through medication, such as dopamine agonists (like cabergoline or bromocriptine), is often the first line of treatment.
- Hormonal Imbalance: The changes in body hair and testicular size may be related to hormonal fluctuations, including testosterone and DHT levels. It’s essential to monitor these levels with your healthcare provider.
- Consultation: Since you’ve already tried HCG and Gonal F, it might be beneficial to discuss further options with an endocrinologist or urologist who specializes in hormonal disorders. They can provide a comprehensive evaluation and suggest appropriate treatments.
Thank you

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Dr. Nikhil Chauhan

I am currently working as a urologist and kidney transplant surgeon at Graphic Era Medical College & Hospital, Dehradun. It's a role that keeps me on my toes, honestly. I handle a pretty wide range of urology cases—stones, prostate issues, urinary tract obstructions, infections, you name it. Some are straightforward, others way more complex than you expect at first glance. Every patient walks in with a different story and that’s what keeps the work real for me. Kidney transplant surgery, though, that’s a whole different zone. You’re not just working on anatomy—you’re dealing with timelines, matching, medications, family dynamics, emotional pressure... and yeah, very precise coordination. I’m part of a team that manages the entire transplant process—from evaluation to surgery to post-op care. Not gonna lie, it’s intense. But seeing someone who’s been on dialysis for years finally get a new shot at life—there’s nothing really like that feeling. In the OR, I’m detail-focused. Outside of it, I try to stay accessible—patients don’t always need answers right away, sometimes they just need to feel heard. I believe in walking them through what’s going on rather than just giving reports and instructions. Especially in transplant cases, trust matters. And clear, honest conversation helps build that. Urology itself is such a misunderstood field sometimes. People ignore symptoms for years because it feels “awkward” or they think it’s not serious until it becomes unmanageable. I’ve had patients who came in late just because they were embarassed to talk about urine flow or testicular pain. That’s why I also try to make the space judgment-free—like whatever it is, we’ll figure it out. At the end of the day, whether I’m scrubbing in for surgery or doing OPD rounds, I just want to make sure what I do *actually* helps. That the effort’s not wasted. And yeah, some days are frustrating—some procedures don’t go clean, some recoveries take longer than they should—but I keep showing up, cause the work’s worth doing. Always is.

62 days ago

Hi, this is a very nice question and also my subject of research. So, sorry for so long reply.
ED is very likely secondary to hyperprolactinemia from prolactin‑secreting microadenoma causing central hypogonadism and low DHT, even if testosterone is in low‑normal range.
First target is strict control of prolactin and tumour: confirm you are on adequate dopamine agonist (usually cabergoline, titrated to normalize prolactin and shrink adenoma) and get regular MRI/endocrine follow‑up.
Once prolactin is normalized, reassess morning total testosterone, LH/FSH and SHBG.
For persistent ED despite corrected hormones, add standard ED measures: weight control, exercise, avoid smoking/alcohol, and consider daily or on‑demand PDE5 inhibitors (tadalafil/sildenafil) after cardiac risk assessment.
If PDE5 inhibitors fail, options include penile injection therapy, vacuum erection device, or ultimately penile prosthesis; early sex‑therapy/psychological support is important as long‑standing ED itself worsens performance anxiety.
HCG/FSH (Gonal‑F) are mainly fertility and testicular‑volume treatments; they help spermatogenesis but usually are not primary therapy for ED unless treating hypogonadotropic hypogonadism with fertility goal.
So, don’t feel doomed. You will be alright after right treatment.
Feel free to contact me for further treatment, as I see these kind of patients daily.
Dr Nikhil Chauhan
Urologist

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Prolactinoma; The Fall of a Young Male - #17151

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