Acquired hypoprolactinemia in men, possible phenotype

Giovanni Corona, Giulia Rastrelli, Clotilde Sparano, Linda Vignozzi, Mario Maggi
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Abstract

The physiological role of prolactin (PRL) in men is still not well defined. The pathological increase is characterized by sexual function impairment along with possible negative consequences in body composition and metabolic profile. Conversely, the clinical significance of reduced PRL levels was only partially investigated or mainly neglected. The present paper aims to summarize and critically discuss possible phenotypes characterizing male subjects with reduced PRL levels. When possible, meta-analytic results were provided. Available data derived from patients seeking medical care for sexual dysfunction as well as from cross-sectional and longitudinal studies showed that low PRL in males is associated with a worse metabolic phenotype (including diabetes mellitus), mood disturbances (including anxiety and depression), and sexual dysfunctions (including psychogenic erectile and ejaculatory dysfunctions). Whether or not these features are direct consequences of reduced PRL levels or whether the latter reflect other pathway impairments such as serotoninergic failure cannot be clarified. The present data, however, emphasize that a deficiency of PRL should be taken into account and need further investigations.

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男性后天性低泌乳素血症,可能的表型
催乳素(PRL)在男性中的生理作用仍未明确。泌乳素病理性增加的特点是性功能受损,同时可能对身体组成和新陈代谢产生负面影响。相反,对 PRL 水平降低的临床意义仅进行了部分研究,或主要被忽视。本文旨在总结和批判性讨论 PRL 水平降低的男性受试者的可能表型特征。在可能的情况下,本文提供了荟萃分析结果。从性功能障碍就医患者以及横断面和纵向研究中获得的现有数据显示,男性PRL水平低与代谢表型(包括糖尿病)、情绪障碍(包括焦虑和抑郁)和性功能障碍(包括精神性勃起和射精功能障碍)相关。这些特征是否是 PRL 水平降低的直接后果,或者后者是否反映了其他途径的损伤,如血清素能衰竭,目前尚不清楚。然而,目前的数据强调,PRL的缺乏应引起重视,并需要进一步的研究。
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