Hyperprolactinemia diagnosis in elderly men: a cohort of 28 patients over 65 years

Shimon, Ilan; Hirsch, Dania; Tsvetov, Gloria; Robenshtok, Eyal; Akirov, Amit; Fraenkel, Merav; Eizenberg, Yoav; Herzberg, Dana; Barzilay-Yoseph, Liat; Livner, Anat; Friedrich, Ilana; Manisterski, Yossi; Ishay, Avraham; Yoel, Uri; Masri, Hiba

doi:10.1007/s12020-019-01962-5

Cited by 18 publications

(11 citation statements)

References 16 publications

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“…In 2019, Shimon et al [ 63 ] evaluated the effect of orally administered cabergoline on testosterone in older men and found that 15 of 21 men with reduced testosterone recovered to normal after a mean follow-up of 5.3 years. However, the follow-up period was not homogeneous in this study and the study endpoint was that most patients’ PRL levels returned to satisfactory levels with the drug; the study did not address the sensitivity of the drug in relation to the recovery of testosterone.…”

Section: Changes In Male Gonadal Function After Treatment Of Pituitar...mentioning

confidence: 99%

Hypogonadism in Male Patients with Pituitary Adenoma and Its Related Mechanism: A Review of Literature

Yan

Lei

2022

Brain Sciences

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Maintaining normal gonadal axis hormone levels is important for improving the condition of male patients with pituitary adenoma. The current literature is somewhat divided on the results of evaluations of gonadal axis function in male patients with pituitary adenoma before and after treatment, and the increasing demand for better quality of life has provided motivation for this research to continue. In this article, we summarize the feasibility of using testosterone as an indicator for assessing male function and discuss the changes reported in various studies for gonadal hormones before and after treatment in male patients with pituitary adenoma. It is important for clinicians to understand the advantages of each treatment option and the effectiveness of assessing gonadal function. The rationale behind the theory that pituitary adenomas affect gonadal function and the criteria for evaluating pituitary–gonadal axis hormones should be explored in more depth.

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Section: Changes In Male Gonadal Function After Treatment Of Pituitar...mentioning

confidence: 99%

Hypogonadism in Male Patients with Pituitary Adenoma and Its Related Mechanism: A Review of Literature

Yan

Lei

2022

Brain Sciences

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“…This is true especially for ED, as suggested by Corona et al, who did not find a significant association between severe hyperprolactinemia and severe ED after adjustment for T levels [29]. On the other side, a direct effect of severe hyperprolactinemia in reducing libido has been demonstrated by some authors [30,31] and may be explained by the presence of PRL receptors in the diencephalic incertohypothalamic dopaminergic system, the most important area for the control of motivational and consummatory aspects of sexual behavior [32]. The normalization of serum PRL levels is therefore recommended for restoration of male sexual desire in patients with hyperprolactinemia and dopamine agonists (bromocriptine and cabergoline) are the first choice, especially for prolactinomas [32].…”

Section: Prolactinmentioning

confidence: 81%

Hypothalamic–Pituitary Diseases and Erectile Dysfunction

Salvio

Martino

Giancola

et al. 2021

JCM

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Several hormones contribute to ensure penile erection, a neurovascular phenomenon in which nitric oxide plays a major role. Erectile dysfunction (ED), which is defined as the persistent inability to obtain or maintain penile erection sufficient for a satisfactory sexual performance, may be due to arteriogenic, neurogenic, iatrogenic, but also endocrinological causes. The hypothalamus–pituitary axis plays a central role in the endocrine system and represents a fundamental link between the brain and peripheral glands, including gonads. Therefore, the hormonal production of the hypothalamic–pituitary axis can control various aspects of sexual function and its dysregulation can compromise erectile function. In addition, excess and deficiency of pituitary hormones or metabolic alterations that are associated with some pituitary diseases (e.g., Cushing’s disease and acromegaly, hypopituitarism) can determine the development of ED with different mechanisms. Thus, the present review aimed to explore the relationship between hypothalamic and pituitary diseases based on the most recent clinical and experimental evidence.

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“…Finally, a total of 146 articles were included in this meta-analysis. Further, 82 of these 146 articles provided data for the DAs group [ 3 – 8 , 13 , 17 – 91 ] and 72 articles provided data for the surgery group [ 3 – 8 , 13 , 68 , 92 – 155 ]. Details of these 146 studies are presented in Table 1 and Supplementary Tables 1 and 2 separately.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 81 studies [ 4 – 8 , 13 , 68 , 84 , 92 – 97 , 99 – 112 , 114 , 118 , 120 – 123 , 125 , 127 – 133 , 135 – 137 , 139 , 141 – 156 ] comprising 4397 patients who received surgery and 74 studies [ 3 – 6 , 8 , 13 , 17 – 21 , 25 , 26 , 28 – 36 , 38 , 42 – 46 , 48 – 51 , 54 – 58 , 60 , 61 , 65 – 73 , 76 , 79 – 81 , 85 – 87 , 89 , 91 ] comprising 2659 patients who used DAs were included in this part of the research. The pooled prolactin normalization rates were 0.66 (0.62, 0.71) ( I 2 = 93.8%, p = 0.000) in the surgery group and 0.78 (0.75, 0.82) ( I 2 = 89.4%, p = 0.000) in the DAs group, respectively (Fig.…”

Section: Resultsmentioning

confidence: 99%

Are dopamine agonists still the first-choice treatment for prolactinoma in the era of endoscopy? A systematic review and meta-analysis

et al. 2022

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Background For prolactinoma patients, dopamine agonists (DAs) are indicated as the first-line treatment and surgery is an adjunctive choice. However, with the development of surgical technique and equipment, the effect of surgery has improved. The aim of this study was to assess the efficacy and safety of surgery versus DAs in patients with different types of prolactinomas. Methods A systematic search of literature using Web of Science, PubMed, Cochrane Library, and Clinical Trial databases was conducted until July 12, 2019. Prolactinoma patients treated with DAs (bromocriptine or cabergoline) or surgery (microscopic or endoscopic surgery) were included. Outcomes included the biochemical cure rate, recurrence rate, prolactin level, improvement rates of symptoms, and incidence rates of complications. A random-effects model was used to pool the extracted data. Qualitative comparisons were conducted instead of quantitative comparison. Results DAs were better than surgery in terms of the biochemical cure rate (0.78 versus 0.66), but surgery had a much lower recurrence rate (0.19 versus 0.57). Full advantages were not demonstrated in improvement rates of symptoms and incidence rates of complications with both treatment options. In microprolactinoma patients, the biochemical cure rate of endoscopic surgery was equal to the average cure rate of DAs (0.86 versus 0.86) and it surpassed the biochemical cure rate of bromocriptine (0.86 versus 0.76). In macroprolactinoma patients, endoscopic surgery was slightly higher than bromocriptine (0.66 versus 0.64) in terms of the biochemical cure rate. Conclusion For patients with clear indications or contraindications for surgery, choosing surgery or DAs accordingly is unequivocal. However, for patients with clinical equipoise, such as surgery, especially endoscopic surgery, in microprolactinoma and macroprolactinoma patients, we suggest that neurosurgeons and endocrinologists conduct high-quality clinical trials to address the clinical equipoise quantitatively.

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Hyperprolactinemia diagnosis in elderly men: a cohort of 28 patients over 65 years

Cited by 18 publications

References 16 publications

Hypogonadism in Male Patients with Pituitary Adenoma and Its Related Mechanism: A Review of Literature

Hypogonadism in Male Patients with Pituitary Adenoma and Its Related Mechanism: A Review of Literature

Hypothalamic–Pituitary Diseases and Erectile Dysfunction

Are dopamine agonists still the first-choice treatment for prolactinoma in the era of endoscopy? A systematic review and meta-analysis

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