[Erectile dysfunction secondary to hyperprolactinemia. Apropos of 13 cases]

Hyperprolactinemia is the cause of erectile dysfunction in less than 1% of cases. From 1989 to 1996, 13 patients consulted for erectile disorders associated with hyperprolactinemia. The mean age was 47.5 years. 10 patients complained of decreased libido. 3 patients had gynecomastia. Plasma prolactin levels ranged from 31.3 ng/ml to 1,300 ng/ml. 7 patients had a plasma testosterone less than 4 ml/ng. 7 patients had a micro- or macroadenoma of the sella turcica visualized by MRI. After drug treatment, plasma prolactin levels returned to normal in all patients in whom assays were performed. 6 patients considered that their erectile function was restored. 5 of the 6 patients with no improvement of their sexual function had a concomitant disease able to explain the impotence. Hyperprolactinemia is a rare cause of erectile dysfunction, but it must be considered in any patient presenting with idiopathic erectile dysfunction associated with decreased libido, gynecomastia, and decreased plasma testosterone. Drug treatment is effective and MRI of the sella turcica should be performed looking for a pituitary adenoma.