Which of the following is a classic presentation of a Prolactinoma?

A prolactinoma is a benign tumor of the pituitary gland that secretes excessive amounts of prolactin, a hormone responsible for milk production and reproductive functions. The classic presentations of a prolactinoma encompass a range of symptoms associated with hyperprolactinemia.

Amenorrhea, which is the absence of menstrual periods, is a common manifestation in women due to disrupted hypothalamic regulation caused by high prolactin levels. Elevated prolactin inhibits gonadotropin-releasing hormone (GnRH) secretion, leading to reduced levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are essential for normal ovulatory cycles.

Galactorrhea, or the inappropriate production of breast milk, often occurs as a direct result of elevated prolactin levels. In women, this can occur regardless of whether they are pregnant or breastfeeding, and it can also appear in men, although it is less common.

Infertility can also be tied to the hormonal imbalances caused by prolactinomas. The inhibition of normal gonadal function due to high levels of prolactin can prevent ovulation in women and reduce testosterone production in men, contributing to infertility.

Since all of these symptoms (