Prevalence and characterization of sexual dysfunctions in male patients with hyperprolactinemia in a national registry

Fraia Antonio De; Elisa Maseroli; Emilia Sbardella; Angelis Cristina de; Marianna Minnetti; Auriemma Renata Simone; Rita Indirli; Caterina Golinelli; Angelo Cignarelli; Linda Vignozzi; Giovanni Corona; Andrea Isidori; Rosario Pivonello

doi:10.1530/endoabs.99.EP1249

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Endocrine Abstracts (2024) 99 EP1249 | DOI: 10.1530/endoabs.99.EP1249

ECE2024 Eposter Presentations Late Breaking (127 abstracts)

Prevalence and characterization of sexual dysfunctions in male patients with hyperprolactinemia in a national registry

Antonio De Fraia ¹ , Elisa Maseroli ² , Emilia Sbardella ³ , Cristina de Angelis ¹ , Marianna Minnetti ³ , Renata Simone Auriemma ¹ , Rita Indirli ⁴ , Caterina Golinelli ⁵ , Angelo Cignarelli ⁶ , Linda Vignozzi ² , Giovanni Corona ⁷ , Andrea Isidori ³ & Rosario Pivonello ¹

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¹Università Federico II di Napoli, Naples, Italy, Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia ed Andrologia, Unità di Andrologia e Medicina della Riproduzione, Sessualità e Affermazione di Genere (Fertisexcares), Italy; ²Università di Firenze, Florence, Italy, Dipartimento di Scienze Sperimentali Cliniche e Biomediche “Mario Serio”; ³Università La Sapienza di Roma, Rome, Italy, Dipartimento di Medicina Sperimentale; ⁴University of Milan, Milan, Italy, Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy - Department of Clinical Sciences and Community Health; ⁵University of Modena and Reggio Emilia, Modena (Italy), Department of Biomedical, Metabolic and Neural Sciences; ⁶Università degli Studi di Bari "Aldo Moro", Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica - (DiMePRe-J);⁷AUSL di Bologna, U.O. di Endocrinologia e Malattie del Ricambio Ospedale Maggiore Bellaria, AUSL di Bologna, U.O. di Endocrinologia e Malattie del Ricambio Ospedale Maggiore Bellaria

Hyperprolactinemia is frequently accompanied by sexual dysfunctions, represented by decreased libido, erectile dysfunction and ejaculatory disorders. Moreover, cabergoline (CAB), used for treatment of hyperprolactinemia, is known to influence sexual function. Aim of the study was to evaluate sexual function in males with hyperprolactinemia under medical therapy. Data were retrieved from GONADIS, a national registry on gonadal status and reproductive and psycho-sexual function in patients affected by pituitary and adrenal disorders, promoted by SIAMS–SIE–AME. Twenty-three male patients aged 25-76 yrs (median age: 49 yrs) with diagnosis of hyperprolactinemia and on therapy with CAB were evaluated. Pharmacological anamnesis, hormonal parameters and standardized questionnaires investigating sexual function (SIEDY, Androtest, IIEF-15, PEDT, MHQ and BDI) were assessed; the cohort was then stratified in “uncontrolled” and “controlled” patients, the latter defined by PRL <16, 5 ng/ml. In overall cohort, 12/23 (52.2%) reached disease control. In overall cohort CAB dose negatively correlated with MHQ-A (r=-0. 652; P=0. 016), MHQ-O (r=-0, 0615; P=0, 025), MHQ-S (r=-0.618; P=0.024), MHQ-D (r=-0.561; P=0, 046) and MHQ-I (r=-0.600; P=0.030) score. In patients with uncontrolled disease, CAB dose positively correlated with IIEF-15 overall satisfaction domain score (r=0.829; P<0.021) and PRL level negatively correlated with IIEF-15 intercourse satisfaction domain score (r=-0.811; P<0.027); in patients with controlled disease, CAB dose negatively correlated with MHQ-S (r=-0.788; P<0.028) and MHQ-H (r=-0.716; P<0.03) score. Our study highlighted that in patients with uncontrolled disease, a worse disease control (i.e. higher PRL levels), is associated with a worse intercourse satisfaction, and that CAB treatment positively impacts on overall satisfaction; this should encourage a tighter disease control by increasing CAB dose. In controlled disease, CAB dose positively impacts on somatization and hysteria traits, which might contribute to general and sexual health. This happens regardless of PRL levels, suggesting that it might be due to its dopaminergic properties.