Symptoms of Pituitary Tumors
Written by: Aaron Cohen-Gadol, MD
Last Updated: September 2, 2023
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In addition to handling the stress of a pituitary tumor diagnosis, it can be difficult to understand the many different symptoms a pituitary tumor can cause. The symptoms a patient can experience depends on what hormone (if any) or pressure symptoms is being secreted or caused by the tumor, respectively. The tumor may cause hormones to be overproduced or underproduced, leading to an array of different symptoms. The symptoms can mimic other medical issues and may be different for each individual. Herein, we’ll attempt to explain different symptoms of specific pituitary tumors.
General Symptoms of Pituitary Tumors
Experiencing a few or many of the following could suggest early signs of a pituitary tumor: headaches (often located in the forehead region and are a constant pain that slowly gets worse), nausea, fatigue, anxiety, vision problems, weight gain, easy bleeding or bruising, menstrual irregularities, abnormal lactation (called galactorrhea), erectile dysfunction, and heat or cold intolerance.
Please note that most people with headaches do not have a pituitary tumor and headaches are rarely the sole presenting symptom of a pituitary tumor. Therefore, any surgical treatment for a small pituitary tumor that is “thought” to only cause headaches must be considered very cautiously.
Patients often wonder if pituitary tumors can cause ear or sinus problems. It is possible, but very rare, for a pituitary tumor to cause these symptoms.
Functional Pituitary Tumors
Pituitary tumors that produce hormones are called functional tumors. The symptoms experienced are a result of the specific hormone that is overproduced. Functional pituitary tumor symptoms in females and males can present very differently. A physician will often order laboratory tests to identify any pituitary hormonal dysfunction.
Prolactin-secreting pituitary adenoma (prolactin): A prolactinoma is caused by the overproduction of the hormone prolactin. In younger women, too much prolactin can inhibit hormones related to the menstrual cycle, causing the cycles to be irregular or stop, leading to infertility issues. A small amount of excess prolactin can cause these symptoms, so pituitary tumors in females are often smaller and detected earlier than in males.
Because men don’t have menstrual periods, prolactinomas are less frequently discovered in males by symptoms alone. Too much prolactin in men can decrease testosterone, leading to fatigue, low libido, and erectile dysfunction. In rare cases, men can experience enlarged breasts and milk production.
Growth hormone-secreting pituitary adenoma (growth hormone): Too much growth hormone can cause a disease called acromegaly in adults and gigantism in children. Growth hormone increases a hormone called insulin-like growth factor that can alter the shape of the body’s internal organs and bones. Acromegaly causes enlarged hands, feet, or other structures like the jaw and forehead. There may be increased skin tags, sweating, arthritis, and sleep apnea. Men may notice that their voice becomes deeper and may notice an increase in their shoe or hat size.
Gigantism can present with many of the same symptoms along with delayed puberty. If either acromegaly or gigantism go untreated for too long, it is possible to develop high blood pressure, diabetes mellitus, and heart disease.
ACTH-secreting pituitary adenoma (adrenocorticotropic hormone): If the pituitary tumor produces too much ACTH, the adrenal gland will generate excess cortisol, known as the stress hormone, leading to Cushing’s disease. Patients may experience increased blood pressure, increased blood sugar, unexplained weight gain (often in the stomach region), muscle wasting, and fragile bones. There can be fat deposits in the face, back of neck, and shoulders, giving a swollen look. The condition can cause purple stretch marks on the stomach and thighs.
TSH-secreting pituitary adenoma (thyroid-stimulating hormone): A pituitary tumor that produces too much TSH is very rare but can lead to hyperthyroidism because TSH increases thyroxine, a hormone that controls the body’s metabolism. Symptoms can include increased sweating, increased heart rate, hand tremors, anxiety, muscle weakness, and weight loss. Women may experience a lighter menstrual flow.
Non-functional Pituitary Tumors
Non-functional pituitary tumors often do not produce any hormone. They are more common than functional pituitary tumors and cause symptoms due to the enlarged pituitary gland pushing on other structures in the brain, including the optic (vision) nerves.
This often causes partial vision loss and headaches. An enlarged pituitary tumor can also compress the normal parts of the pituitary gland, preventing it from producing enough hormones. For example, growth hormone deficiency can stunt puberty in children. In adults, this deficiency is less drastic but may result in muscle loss. Similarly, a reduction in ACTH can lead to fatigue and low blood pressure while reduced TSH can cause weight gain and fatigue.
Key Takeaways
Learning that pituitary tumors can cause many symptoms related to specific hormones or an enlarged pituitary gland can help patients understand what physiological processes are happening in their body. This can empower patients and decrease anxiety as they move forward with a treatment plan.
- Common pituitary tumor symptoms are headaches, nausea, fatigue, anxiety, vision problems, weight gain, easy bleeding or bruising, menstrual irregularities, lactation, erectile dysfunction, and heat or cold intolerance.
- It is rare that pituitary tumors will directly cause nose pain or pressure.
- Hormones that are often overproduced due to pituitary tumors are prolactin, growth hormone, ACTH and TSH. All of these cause specific symptoms patients can identify.
