Erectile Dysfunction In Patients With Hyperprolactinemia

Efremov E.A., Gusakova D.A., Mel'nik Ya.I.

Relevance. In males with sexual dis­orders hyperprolactinemia is deter­mined in 0,4-11% of cases, and in some studies achieves 20%, due to which assessment of the prolactin level in blood is an important part of erectile dysfunction diagnostics. Objective. To study frequency of oc­currence and general clinical presen­tation of hyperprolactinemia in pa­tients with erectile dysfunction (ED). Materials and methods. We have ex­amined a big group of patients with ED of different etiology. Hyperpro­lactinemia was detected in 69 (9%) patients of general group. Retrospec­tively in these patients with hyper­prolactinemia clinical presentation was dominantly of an endocrine character. Decrease or absence of li­bido in 58 (84%), gynecomastia - 12 (17,4%), galactorrhea - 2 (2,9%), a rare beard growth were observed in 4 (5,8%) patients. Prolactin level in blood serum was in range 360 - 8000 mU/l (average 1200 mU/l, normal values < 360). Hypophysis visualiza­tion was performed in case of pro­lactin level increase. CT (62%) or MRI (38%) revealed pituitary mac­roadenomas in 30 (43,5%) patients, pituitary microadenomas in 21 (30,4%) patients and did not reveal any pathologic changes in 18 (26,1%) patients. 20 patients (28,9%) with hy­perprolactinemia had low levels of testosterone. During the treatment (bromocriptine 1,25 mg 2-3 times daily, gradually increasing the dose of 5-10 mg / day for 1-2 months) we found that at the background of hy­perprolactinemia erectile function is inhibited regardless of androgen status.
Conclusion. Thus we can say that evaluation of prolactin concentration in blood is an important part in di­agnostics of ED etiology and must be performed in all patients complaints of erection quality reduce.

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