Prolactin-Secreting Tumors and Hypogonadism in 22 Men

TLDR

We studied 22 men with prolactin‑secreting pituitary tumors and hypogonadism. Among these patients, 20 reported impotence, 9 had visual impairment, and 3 experienced galactorrhea; surgery or radiotherapy alone did not normalize prolactin in 17 patients, whereas bromocryptine therapy in 13 patients produced major clinical improvement with decreased prolactin and increased testosterone in nine, and impotence improved only after bromocryptine in two patients on testosterone replacement, indicating hyperprolactinemia frequently induces hypogonadism and bromocryptine can relieve symptoms unresponsive to surgery or radiotherapy, while impotence may not be solely due to hypogonadism.

Abstract

We studied 22 men with prolactin-secreting pituitary tumors and hypogonadism. Twenty complained of impotence, nine had visual impairment, and three experienced galactorrhea. None of the 17 patients undergoing operation or radiotherapy, or both, were subsequently normoprolactinemic. In all 13 patients treated with bromocryptine major clinical improvement was associated with a decrease in serum prolactin levels and in nine with an increase in serum testosterone. Two patients receiving testosterone replacement therapy showed improved potency only after bromocryptine was administered. The results indicate that hyperprolactinemia frequently induces hypogonadism in men, that bromocryptine ameliorates symptoms of disease previously unchanged by operation or radiotherapy, and that the impotence observed may not be solely the result of hypogonadism.