Hyperprolactinaemia in Men?response to Bromocriptine Therapy

Prescott, R. W. G.; Kendall‐Taylor, P.; Hall, K.; Johnston, Desmond G.; Crombie, A. L.; McGregor, A M

doi:10.1016/s0140-6736(82)90975-8

Cited by 76 publications

(26 citation statements)

References 28 publications

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“…Although severe hyperprolactinemia is usually associated with hypogonadism, a direct effect of prolactin on sexual desire was also hypothesized, 8 because in hyperprolactinemic patients testosterone treatment was not able to restore libido, 24 while prolactinlowering drugs were very effective. 5,6 Interestingly, in hyperprolactinemic patients, testosterone was in the normal range. It is possible, therefore, to miss a significant hyperprolactinemia if only serum testosterone is measured during the initial screening, in particular in ED patients complaining loss of libido as previously reported.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6] However, both disorders have a low prevalence among subjects with ED, [7][8][9] and can therefore account only for a small minority of cases of HSD. Many other conditions, including mental disorders, medications, and physical or psychological distress, 1,3 have been evoked as the possible pathogenetic factors for loss of desire; however, their contribution to the impairment of libido in patients with ED has not been systematically studied so far.…”

Section: Introductionmentioning

confidence: 99%

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Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction

et al. 2004

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We studied the psychological and biological correlates of hypoactive sexual desire (HSD) in a consecutive series of 428 patients with erectile dysfunction (ED), by using the structured interview SIEDY r . A complete physical examination and a series of biochemical, hormonal, psychometric, and penile vascular tests were also performed. Among the patients studied, 22.8% reported a mild, 12.9% a moderate, and 4.6% a complete loss of sexual interest. Patients reporting HSD showed significantly lower testosterone (T) levels than the rest of the sample, although the prevalence of hypogonadism (To10 nM) was comparable in the two groups. Only a minority (o2%) had severe hyperprolactinemia (4700 mU/l), which, nonetheless, was closely associated with a relevant HSD. Both mental disorders and use of medication interfering with sexual function were significantly associated with HSD, as well as depressive and anxiety symptoms. HSD patients showed significantly higher scores in SIEDY r scale 2, which explores the relational component of ED. In particular, perceived partner's libido and climax were crucially associated with an impairment of patients' sexual desire. In conclusion, HSD in ED is associated with several biological, psychological, and relational factors that can be simultaneously identified and quantified using the SIEDY r structured interview.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction

et al. 2004

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“…When the androgen is replaced, the erectile response fully recovers [6,13]. In men, erectile dysfunction and low blood testosterone levels are problems in patients undergoing renal dialysis [14], men with prolactin-secreting pituitary adenomas [15], and during some anti-androgen treatments [16][17][18][19]. After treatment with androgens, hypogonadal, impotent men reported an increase in the number of erections, nocturnal penile tumescence, episodes of masturbation [20], and sexual desire [21].…”

Section: Discussionmentioning

confidence: 99%

Androgenic Maintenance of Inflow and Veno-Occlusion during Erection in the Rat

Mills

Lewis

Stopper

1998

Biology of Reproduction

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Ongoing studies in this laboratory are designed to determine the role of androgens in the maintenance of the erectile response in the rat. Testosterone-treated castrated rats (TESTO) and untreated castrated rats (CASTRATE) were used for measurement of the rate at which blood flows into the cavernous sinuses by timed collections of blood after partial amputation of the penis. A laser Doppler flow meter was employed to determine whether androgens also regulate the veno-occlusive mechanism that controls the rate of blood flow out of the sinuses. Erection was induced by direct electrical stimulation of the autonomic ganglion that controls cavernosal blood flow in the erectile response. The results of these studies showed that blood flow into the sinuses was approximately twice as great in the TESTO animals as the CASTRATE rats. Furthermore, during ganglionic stimulation, veno-occlusion occurred in the TESTO rats but failed to occur in the CASTRATE rats. The dependence of these responses on nitric oxide (NO) was demonstrated by showing that injection of sodium nitroprusside (SNP) enhances the intracavernosal pressure response in TESTO rats but not CASTRATE animals. However, when SNP injection was combined with ganglionic stimulation, veno-occlusion did occur in the CASTRATE animals. Taken together, these studies show that both the rate of blood flow into the cavernous sinuses and the blood flow out are under androgenic regulation and may involve the actions of NO.

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“…Although symptoms of hypogonadism are still the most prevalent, symptoms due to mass effects commonly serve as those that prompt medical attention and lead to the diagnosis. A summary of 16 series comprising 444 men with prolactinomas indicates that 77.9% were impotent, 36.6% had visual field defects, 33.8% had partial or complete hypopituitarism, 29.1% complained of headaches, and only 10.9% had galactorrhea (60, 64,75,85,114,115,[431][432][433][434][435][436][437][438][439][440][441]. Thus, about one third of men have symptoms due to tumor size.…”

Section: A Prolactinomas In Malesmentioning

confidence: 99%

Advances in the Treatment of Prolactinomas

et al. 2006

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Prolactinomas account for approximately 40% of all pituitary adenomas and are an important cause of hypogonadism and infertility. The ultimate goal of therapy for prolactinomas is restoration or achievement of eugonadism through the normalization of hyperprolactinemia and control of tumor mass. Medical therapy with dopamine agonists is highly effective in the majority of cases and represents the mainstay of therapy. Recent data indicating successful withdrawal of these agents in a subset of patients challenge the previously held concept that medical therapy is a lifelong requirement. Complicated situations, such as those encountered in resistance to dopamine agonists, pregnancy, and giant or malignant prolactinomas, may require multimodal therapy involving surgery, radiotherapy, or both. Progress in elucidating the mechanisms underlying the pathogenesis of prolactinomas may enable future development of novel molecular therapies for treatment-resistant cases. This review provides a critical analysis of the efficacy and safety of the various modes of therapy available for the treatment of patients with prolactinomas with an emphasis on challenging situations, a discussion of the data regarding withdrawal of medical therapy, and a foreshadowing of novel approaches to therapy that may become available in the future.

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Hyperprolactinaemia in Men?response to Bromocriptine Therapy

Cited by 76 publications

References 28 publications

Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction

Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction

Androgenic Maintenance of Inflow and Veno-Occlusion during Erection in the Rat

Advances in the Treatment of Prolactinomas

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