A prolactin-secreting pituitary adenoma presents with which symptom combination?

• A. Weight gain and fatigue
• B. Headache and blurred vision
• C. Hyperthyroidism symptoms
• D. Galactorrhea and amenorrhea (often infertility)

Answer: (D)

Elevated prolactin from a pituitary adenoma disrupts the reproductive hormone axis. Prolactin inhibits the hypothalamic release of GnRH, which lowers LH and FSH. That dampens ovulation and leads to amenorrhea, while prolactin also drives breast tissue to produce milk, causing galactorrhea. Because of these hormonal effects, the classic presenting symptom pair is galactorrhea with amenorrhea, often with fertility issues. Larger tumors can cause headaches or blurred vision due to pressure on surrounding structures, but the reproductive effects are the most characteristic features.