Low Prolactin Is Associated with Sexual Dysfunction and Psychological or Metabolic Disturbances in Middle-Aged and Elderly Men: The European Male Aging Study (EMAS)

Abstract

Introduction We previously reported that in male patients consulting for sexual dysfunction, low prolactin (PRL) levels were associated with metabolic syndrome (MetS), arteriogenic erectile dysfunction, and incident major cardiovascular events. Aim The aim of this study is to assess the clinical associations of PRL levels in the European Male Ageing Study (EMAS). Methods EMAS is a prospective, observational cohort of community-dwelling men aged 40–79 years old (mean age 60 ± 11 years old). PRL was available for 2,948 men. Main Outcome Measures Different parameters were evaluated including the Short Form-36 questionnaire, Becks Depression Inventory, the Adverse Life Events Scale, the Physical Activity Scale for the Elderly, and the EMAS sexual function questionnaire (EMAS-SFQ). Results After the adjustment for confounders, PRL levels were inversely related with worsening of sexual function as compared with the previous year, as derived from change in sexual functioning domain of the EMAS-SFQ (adj. r = −0.043; P = 0.029). The strongest correlation (Wald = 6.840; P = 0.009) was observed between lower PRL levels and reduced enjoyment of orgasmic experiences. Furthermore, an inverse relationship between PRL levels and stressful life events or depressive symptoms was observed. Low PRL was also negatively associated with an unhealthy metabolic phenotype as well as with the MetS (Wald = 5.229; P = 0.022). In line with these data, low PRL was associated with a lower level of physical activity and feeling unhealthier. Conclusions Low PRL is related to several metabolic, psychological, and sexual unhealthy characteristics in European men. Checking PRL might be useful to stratify men for cardiovascular risk and to encourage appropriate lifestyle changes.

Psychological, Relational, and Biological Correlates of Ego-Dystonic Masturbation in a Clinical Setting

“…From an etiologic viewpoint, this lack of association appeared to contradict the involvement of testosterone-mediated mechanisms in the pathogenesis of EM 42 . The association of EM with lower levels of prolactin is in line with previous findings, which showed an association between decreased prolactin levels and anxious 43 or depressive 44 symptomatology, most probably because it reflects a lower central serotoninergic tone 45 . Animal models also have shown that prolactin levels in the brain contribute to the modulation of neuronal circuits involved in the regulation of stress responses 46, 47, 48.…”

Association between serum prolactin levels and insulin resistance in non-diabetic men

“…Furthermore, bromocriptine, a dopamine agonist that is well known to suppress serum PRL levels, has been shown to effectively improve insulin sensitivity, and has been approved for the treatment for type 2 diabetes mellitus in the United Sates [19]. In contrast, other studies have shown an inverse association between serum PRL levels and metabolic parameters such as cardiovascular events [20], cardiac remodeling [21], diabetes [22,23], metabolic syndrome [22,24], homeostasis model assessment (HOMA) for insulin resistance [25], and adverse lipid profiles [26]. Therefore, the association between serum PRL levels and metabolism in subjects with serum PRL levels within the physiological range requires further evaluation.…”

“…However, most previous studies have been conducted in either individual gender alone [15–18, 20, 24–26]. Some studies with subjects stratified based on gender did show gender-specific association between serum PRL levels and glucose-induced insulin release [27], cardiac remodeling [21], and metabolic syndrome [22].…”

How predictable is the erectile function of patients with epilepsy?

“…A contrasting finding was recently reported by a European observational cohort study of 2948 communitydwelling men [41].…”