What Are Pituitary Tumors?

Pituitary tumors, also called pituitary adenomas, are growths that form in the pituitary gland. This small gland sits at the base of the brain behind the bridge of your nose and produces hormones that control many bodily functions. Despite their location in the brain, these tumors are almost always benign (non-cancerous).

These tumors are categorized based on their size and hormone production. Microadenomas are smaller than 10mm, while macroadenomas are larger than 10mm. Functional tumors produce excess hormones, while non-functional tumors don't secrete hormones but can cause problems by pressing on surrounding structures. About 10,000 pituitary tumors are diagnosed each year in the United States, though many more likely exist without causing noticeable symptoms.

Common Hormone-Related Symptoms

Many pituitary tumor symptoms result from hormonal imbalances. These symptoms vary widely depending on which hormones are affected:

Growth Hormone Excess: In adults, too much growth hormone can cause a condition called acromegaly, characterized by enlarged hands and feet, coarsened facial features, increased sweating, joint pain, and deepening of the voice. In children, it can lead to gigantism, causing abnormal height increases and growth.

Prolactin Excess: High prolactin levels can cause irregular menstrual periods or stopped periods in women, decreased sex drive, and inappropriate milk production from the breasts (galactorrhea). In men, it can cause erectile dysfunction, decreased libido, and breast enlargement.

Cortisol Excess: When a tumor triggers overproduction of ACTH (which stimulates cortisol production), it can lead to Cushing's syndrome. Symptoms include weight gain (especially in the face, neck, and trunk), purple stretch marks, easy bruising, muscle weakness, mood changes, and high blood pressure.

Pressure-Related Symptoms

Larger pituitary tumors can press on nearby structures, causing symptoms unrelated to hormone production:

Vision Problems: The pituitary gland sits close to the optic nerves and chiasm. Pressure from a growing tumor can cause vision loss, particularly peripheral (side) vision, or double vision. These visual field defects often develop gradually and may go unnoticed initially.

Headaches: Persistent headaches, especially those centered behind the eyes or in the temples, can result from a pituitary tumor expanding and pressing on surrounding structures. These headaches may not respond well to typical pain relievers.

Neurological Issues: In some cases, larger tumors can cause facial numbness or pain, seizures, or difficulty with balance and coordination if they extend beyond the pituitary region.

Hormone Deficiency Symptoms

Sometimes, rather than causing hormone overproduction, pituitary tumors can damage the normal gland tissue and lead to hormone deficiencies. This condition, called hypopituitarism, can affect multiple hormone systems:

Thyroid Hormone Deficiency: Low levels of thyroid stimulating hormone (TSH) can lead to hypothyroidism, with symptoms including fatigue, cold intolerance, weight gain, dry skin, and constipation.

Sex Hormone Deficiency: Decreased levels of sex hormones can cause reduced fertility, menstrual irregularities in women, erectile dysfunction in men, decreased libido, and loss of body hair.

Adrenal Hormone Deficiency: Insufficient ACTH production can lead to adrenal insufficiency, causing weakness, fatigue, low blood pressure, and poor stress response. In severe cases, this can be life-threatening during illness or stress.

Diagnosis and Treatment Options

If you experience multiple symptoms suggesting a pituitary tumor, medical evaluation is essential. Diagnosis typically involves:

Blood and Urine Tests: These measure hormone levels to identify imbalances. Multiple tests may be needed since hormone levels can fluctuate throughout the day.

Imaging Studies: Mayo Clinic specialists often use magnetic resonance imaging (MRI) to visualize the pituitary gland and detect tumors. CT scans may sometimes be used as an alternative.

Vision Testing: Comprehensive eye exams, including visual field testing, can detect vision changes caused by tumors pressing on the optic nerves.

Treatment approaches vary based on tumor type, size, and symptoms. Options include:

Medication: Certain drugs can reduce tumor size and normalize hormone production. Pituitary Society resources indicate that prolactinomas, the most common type of pituitary tumor, often respond well to medication alone.

Surgery: Transsphenoidal surgery (through the nose and sphenoid sinus) is the most common approach for removing pituitary tumors. National Institute of Diabetes and Digestive and Kidney Diseases research shows this minimally invasive procedure has high success rates with experienced surgeons.

Radiation Therapy: For tumors that can't be completely removed or that recur after surgery, radiation therapy may be recommended to control growth and hormone production.

Conclusion

Pituitary tumors can cause diverse symptoms that often develop gradually, making them challenging to recognize. Being aware of unusual changes in your body—particularly those affecting vision, energy levels, weight, sexual function, and menstrual cycles—can help identify potential pituitary issues earlier. While these symptoms can be caused by many other conditions, persistent or worsening signs warrant medical evaluation.

With modern diagnostic techniques and treatment options, the outlook for people with pituitary tumors is generally positive. Most tumors can be effectively managed through medication, surgery, or radiation therapy. Regular follow-up care is important, as some tumors may recur or require ongoing hormone management. If you're experiencing concerning symptoms, consult with healthcare providers at centers like Johns Hopkins Medicine that specialize in pituitary disorders for proper evaluation and personalized treatment planning.

Citations

This content was written by AI and reviewed by a human for quality and compliance.