[Gender-specific features of hyperprolactinemia syndrome]

Area of Science:

• Endocrinology
• Oncology
• Clinical Medicine

Context:

• Hyperprolactinemia, characterized by elevated prolactin levels, affects both men and women.
• Distinguishing clinical features and tumor characteristics between sexes is crucial for effective management.
• Understanding these differences aids in early diagnosis and tailored treatment strategies.

Purpose:

• To investigate and compare the clinical manifestations of hyperprolactinemia in male and female patients.
• To analyze differences in diagnostic timelines, tumor characteristics (frequency, size, invasiveness), and prolactin levels between sexes.
• To evaluate the etiological factors, including tumorous and non-tumorous origins, influencing these clinical presentations.

Summary:

• A study of 286 patients (148 men, 138 women) with hyperprolactinemia revealed significant sex-based differences.
• Men experienced a longer diagnostic delay and presented with more aggressive, larger, and invasive prolactin-secreting pituitary tumors (macroprolactinomas) compared to women.
• While macroprolactinemia was more common in women, men with tumorous hyperprolactinemia exhibited higher total and monomeric prolactin (PRL) levels.

Impact:

• Highlights the need for sex-specific diagnostic and treatment approaches for hyperprolactinemia.
• Provides insights into the differential growth patterns of prolactinomas in men and women.
• Emphasizes the importance of considering tumor invasiveness and prolactin levels in sex-based comparisons for better patient outcomes.