Twenty years experience with male prolactinomas
Issue: 1/1998
Author: Ph. Kumanov, A. Tomova, M. Andreeva, Clinical Centre of Endocrinology and gerontology, Medical University – Sofia
Abstract:
Prolactinomas in men are rare, there is delay in diagnosis and the studies on them are still rather insufficient. For a 20-years period (from 1978 to 1997) we have studied 12 men with prolactinomas (in 81,82% macroprolactinomas). The main clinical characteristics included decreased libido, erectile dysfunction and ejaculatory disturbance. The serum basal prolactin concentrations were between 1775 and 17200 mlU/1 (mean ± SD; 6303.15 ± 4237.99 mlU/1); the levels of luteinizing hormone (3.57 ± 1.38 IU/1); follicle-stimulating hormone (1.65 ± 0.91 IU/1) and testosterone (5.55 ± 2.50 nmol/1) were significantly lower than those in healthy control males. The concentrations of thyroid stimulating hormone (TSH) (7.07 ± 5.04 mlU/1) were found significantly elevated and the response of TSH after thyrotropin releasing hormone in two of the patients was enhanced.
Eight patients have been surgically treated by transsphenoidal access. Transcranial operation followed by irradiation was performed in one male and the rest three patients were treated with bromocriptin per os. Treatment with dopamine agonists was required in some operated subsects.
Even the slightest disturbances of the gonadal axis in men should be purposefully clarified, so that early diagnosis of male prolactinomas and better theurapeutic results are achieved.
Keywords: prolactinoma, prolactin, gonadal axis.
