[Hyperprolactinemia and sexual activity of men--clinical aspect]

Hyperprolactinemia, particularly resulting from microprolactinoma, is known to induce erectile dysfunction. Contemporary published data do not allow to ascertain which prolactin (PRL) levels result in this type of sexual dysfunctions. The aim of this study was to evaluate the relationship between the extent of hyperprolactinemia and erectile dysfunction in 9 men with microprolactinoma and 8 patients with hyperprolactinemia as side-effects of sulpiride therapy. In all hyperprolactinemic males plasma PRL, LH, FSH and total testosterone levels were measured. The results showed that all patients with iatrogenic hyperprolactinemia were characterised by satisfactory sexual activity, although in 3 men hypotestosteronemia was revealed and in one patient gynecomastia was found. A range of PRL levels was 35-108 ng/ml. Among men with microprolactinoma the capability to lead a satisfactory sexual activity existed, even though in one patient PRL level was 2177 ng/ml, but in 3 other patients importance was observed when PRL concentrations were 281, 195 and 328 ng/ml. After bromocriptine therapy, when PRL levels diminished until 189, 78.3 and 110 ng/ml, the erectile dysfunction disappeared. Authors presume that sexual dysfunctions are not strictly connected with hyperprolactinemia and/or hypotestosterionemia, but probably are conditioned by other unexplicit factors (for example: a heterogeneous structure of PRL complexes).