Hyperprolactinemia and sexual disorders in men

One hundred and thirty-six men, who presented at Masters & Johnson Institute for treatment of impotence, ejaculatory incompetence, and inhibited sexual desire, underwent endocrine screening. Eleven men (8.1%) were found to be hyperprolactinemic: three had a mild degree of hyperprolactinemia while eight had markedly elevated serum prolactin levels in conjunction with subnormal serum testosterone levels. The markedly hyperprolactinemic men, all of whom were subsequently found to have prolactin-secreting pituitary adenomas, presented with diverse histories of sexual disorders which were similar to those of men with psychogenic sexual dysfunctions. All eight experienced some degree of improvement of sexual function following a 2-week course of intensive psychotherapy, although full restoration of libido was contingent on reduction of circulating prolactin to normal or near-normal levels. Measurement of prolactin levels should be routinely performed in all men presenting with the above sexual disorders and depressed testosterone levels.