Sexual function and depressive symptoms in young women with elevated macroprolactin content: a pilot study

Abstract

Elevated prolactin levels seem to be associated with impaired sexuality. The clinical significance of macroprolactinemia, associated with the predominance of high molecular mass circulating forms of prolactin, is still poorly understood. This study was aimed at investigating sexual function in young women with macroprolactinemia. The study enrolled 14 young women with macroprolactinemia, 14 with increased monomeric prolactin levels, as well as 14 age- and weight-matched healthy women. All patients completed a questionnaire evaluating female sexual function (Female Sexual Function Index—FSFI), as well as a questionnaire assessing the presence and severity of depressive symptoms (Beck Depression Inventory Second Edition—BDI-II). Apart from total prolactin levels and macroprolactin content, circulating levels of thyrotropin, total testosterone, and 17-β estradiol were also measured. Patients with elevated monomeric prolactin levels had a lower total FSFI score, as well as lower scores for all domains: sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction, and dyspareunia. These scores correlated with total and monomeric prolactin levels. In turn, women with macroprolactinemia were characterized by a lower score for sexual desire, and only this score correlated with total prolactin levels and macroprolactin content. The total score in the BDI-II questionnaire was higher in patients with hyper- and macroprolactinemia than in the control subjects. Contrary to multidimensional impairment of sexual function in women with elevated monomeric prolactin, macroprolactinemia only seems to disturb sexual desire.

Funkcjonowanie seksualne i objawy depresyjne u kobiet z różnymi typami stanu przedcukrzycowego — badanie pilotażowe

“…Moreover, correlations between HOMA1-IR and desire were stronger than correlations between insulin resistance and arousal, lubrication, orgasm, satisfaction, and pain. Interestingly, in our recent study, only sexual desire was disturbed in young women with macroprolactinaemia, which contrasted with multidimensional impairment of sexual function in women with elevated monomeric prolactin, probably because the amount of monomeric prolactin released locally from macroprolactin complexes is lower than that found in patients with monomeric hyperprolactinaemia [39]. Furthermore, apart from arousal, only desire was disturbed among all groups of women with thyroid disease: women with euthyroid Hashimoto's thyroiditis, non-autoimmune hypothyroidism, and autoimmune thyroid hypofunction [40].…”

Funkcjonowanie seksualne i objawy depresyjne u młodych mężczyzn z niedoczynnością tarczycy leczonych terapią skojarzoną z zastosowaniem lewotyroksyny i liotyroniny

“…Higher total scores indicate more severe depressive symptoms. Based on the overall BDI-II score, depressive symptoms are classified as minimal (0-13), mild (14)(15)(16)(17)(18)(19), moderate (20)(21)(22)(23)(24)(25)(26)(27)(28), or severe (29-63) [16].…”

“…However, it is lower than the molar proportion of daily secretion of thyroxine and triiodothyronine (14:1) by the human thyroid gland [20,29]. This fact suggests a relative excess of liothyronine, which, unlike levothyroxine, is characterised by a short half-life, leading to widely varying serum levels of this hormone [30].…”

“…Although no data are available for men, macroprolactinaemia and vitamin D insufficiency, representing mild endocrinopathies, were accompanied by isolated hypolibidaemia in women [20,21]. In turn, more severe forms of prolactin excess and of hypovitaminosis D were associated with disturbances of other aspects of sexual functioning [20,21].…”

“…Although no data are available for men, macroprolactinaemia and vitamin D insufficiency, representing mild endocrinopathies, were accompanied by isolated hypolibidaemia in women [20,21]. In turn, more severe forms of prolactin excess and of hypovitaminosis D were associated with disturbances of other aspects of sexual functioning [20,21]. What is more, irrespectively of gender, serum androgen levels correlated better with desire than with other domains of male and female sexual functioning [22][23][24].…”