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Warning-sign checks

Prolactinoma: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Seek emergency medical care for:

    • A sudden, extremely severe headache
    • Sudden loss or marked worsening of vision
    • New double vision with a severe headache
    • A drooping eyelid, confusion, collapse, or repeated vomiting with headache

    These symptoms can occur with pituitary apoplexy or serious pressure on nearby nerves.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Arrange prompt medical assessment for gradually worsening vision, persistent new headaches, or symptoms suggesting loss of other pituitary hormones, such as severe weakness or unexplained faintness.

    Headache or visual changes during pregnancy also need prompt assessment in someone with a known prolactinoma.

  3. 3

    Does any of this apply?

    Book an appointment

    Routine assessment is appropriate for unexplained milk leakage, absent or irregular periods, erectile difficulties, low sex drive, or difficulty becoming pregnant.

    These symptoms have many possible causes and do not by themselves mean that you have a prolactinoma.

The article also says

If you are already being treated, contact your healthcare team about troublesome side effects, new compulsive behaviour, pregnancy plans, or a positive pregnancy test.

Do not stop a dopamine agonist suddenly unless you have been told how to manage it.

Every sign above is quoted from the sofidex article on Prolactinoma. If you are not sure, err upward — it is always reasonable to be checked.