One hundred impotent men and 15 sexually active male volunteers served as the source for this study. Serum prolactin was estimated in all cases using radioimmunoassay technique. Cases with hyperprolactinemia were treated with bromocriptin for 3 months. Hyperprolactinemia was detected in three patients only (3%), with no findings of pituitary tumors. Treatment with bromocriptin markedly reduced the level of serum prolactin together with improvement of sexual libido and potency. The mere presence of 3 cases only with hyperprolactinemia among 100 impotent subjects suggested that hyperprolactinemia is not one of the main causes of impotence.
Summary
An analysis of the gonadotrophin response to an intravenous injection of LH‐RH (50 μg) has been undertaken in 41 patients with secondary amenorrhoea. Thirtyfive of the patients were free of any recognizable pathology to account for their amenorrhoea and apparently had a dysfunction of the hypothalamic‐pituitary axis. In these patients, the gonadotrophin response to LH‐RH was highly variable. There was in general a correlation between baseline plasma LH or FSH levels and their respective increments. There was no correlation, however, between basal oestrogen levels and gonadotrophin increments except in the case of those patients whose basal levels of plasma FSH were higher than those of LH and in those patients whose body weight was less than the ideal for the population. It appears that the gonadotrophin response to a single injection of LH‐RH in the majority of patients with secondary amenorrhoea of unknown origin is too variable to be of use either as a diagnostic or prognostic tool.
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