TOPLINE

Fatigue and cognitive complaints were the most prevalent symptoms in women with a prolactinoma. Although those with controlled disease reported better health-related quality of life and lower disease burden, psychological and cognitive symptoms persisted despite biochemical control.

METHODOLOGY

• Researchers conducted a cross-sectional analysis of data from two cohort studies to compare patient-reported symptoms, health-related quality of life, anxiety and depressive symptoms, and disease burden in women with a prolactinoma according to disease activity. 
• They included 450 women with a prolactinoma (median age, 36.4 years) who completed at least one patient-reported outcome measure; of these, 223 had active disease (prolactin levels above the upper limit of normal [ULN]) and 227 had controlled disease (prolactin levels below the ULN) — including those controlled on dopamine agonists and those in biochemical remission.
• All outcomes were evaluated using standardised questionnaires, and statistical modelling was performed to identify factors affecting emotional well-being and social functioning. 

TAKEAWAY

• Fatigue was the most prevalent symptom in women with both active (92.7%) and controlled (86.4%) disease, followed by concentration problems (79.0% and 64.5%, respectively).
• Women with controlled disease reported better health-related quality of life than those with active disease. They also had significantly lower anxiety and depression scores (P < .001) and disease burden (P < .05) than those with active disease; however, symptoms such as fatigue, concentration problems, and even galactorrhoea (in ~21% of women) persisted despite normalised prolactin.
• Clinically relevant anxiety and depression were present in nearly half (48.5%) and over 40% of women with active disease, respectively — and still notable in those with controlled disease (32.8% and 25.1%, respectively).
• Active disease and younger age were independently associated with worse emotional well-being and social functioning, effects that were largely mediated by prolactinoma-related symptoms such as concentration problems, loss of libido, fatigue, and galactorrhoea.

IN PRACTICE

"This large multicenter study sheds light on symptomology, disease burden and HR-QoL [health-related quality of life] in females with a prolactinoma among whom the majority had previously been treated or were currently receiving treatment," the authors wrote.

"Optimalisation of treatment modalities and rehabilitation strategies is important as physical, cognitive, and psychological complaints persist despite disease control," they added.

SOURCE

This study was led by Victoria R. van Trigt and Iris C.M. Pelsma, Department of Medicine, Division of Endocrinology, and Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, Netherlands. It was published online on August 13, 2026, in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS

The study included only women. Missing data due to 13% of patients not completing the questionnaires may have slightly skewed the results.

DISCLOSURES

This study received partial funding from ZonMw. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.