Hormonal Causes of Male Sexual Dysfunctions and Their Management (Hyperprolactinemia, Thyroid Disorders, GH Disorders, and DHEA)

被引:91
作者
Maggi, Mario [1 ]
Buvat, Jaques [2 ]
Corona, Giovanni [1 ,3 ]
Guay, Andre [4 ]
Torres, Luiz Otavio
机构
[1] Univ Florence, Sexual Med & Androl Unit, Dept Clin Physiopathol, I-50139 Florence, Italy
[2] Ctr Etud & Traitement Pathol Appareil Reprod & Ps, Lille, France
[3] Azienda Usl Bologna Maggiore Bellaria Hosp, Endocrinol Unit, Dept Med, Bologna, Italy
[4] Lahey Clin Fdn, Ctr Sexual Funct Endocrinol, Peabody, MA USA
关键词
Prolactin; DHEA; Thyroid Hormone; GH; GROWTH-FACTOR-I; CENTRAL SEROTONERGIC RESPONSIVITY; DIETARY-SUPPLEMENT PRODUCTS; ERECTILE DYSFUNCTION; BODY-COMPOSITION; DOUBLE-BLIND; DEHYDROEPIANDROSTERONE DHEA; PREMATURE EJACULATION; ADRENAL INSUFFICIENCY; HYPER-PROLACTINEMIA;
D O I
10.1111/j.1743-6109.2012.02735.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Introduction. Besides hypogonadism, other endocrine disorders have been associated with male sexual dysfunction (MSD). Aim. To review the role of the pituitary hormone prolactin (PRL), growth hormone (GH), thyroid hormones, and adrenal androgens in MSD. Methods. A systematic search of published evidence was performed using Medline (1969 to September 2011). Oxford Centre for Evidence-Based MedicineLevels of Evidence (March 2009) was applied when possible. Main Outcome Measures. The most important evidence regarding the role played by PRL, GH, thyroid, and adrenal hormone was reviewed and discussed. Results. Only severe hyperprolactinemia (>35ng/mL or 735mU/L), often related to a pituitary tumor, has a negative impact on sexual function, impairing sexual desire, testosterone production, and, through the latter, erectile function due to a dual effect: mass effect and PRL-induced suppression on gonadotropin secretion. The latter is PRL-level dependent. Emerging evidence indicates that hyperthyroidism is associated with an increased risk of premature ejaculation and might also be associated with erectile dysfunction (ED), whereas hypothyroidism mainly affects sexual desire and impairs the ejaculatory reflex. However, the real incidence of thyroid dysfunction in subjects with sexual problems needs to be evaluated. Prevalence of ED and decreased libido increase in acromegalic patients; however, it is still a matter of debate whether GH excess (acromegaly) may create effects due to a direct overproduction of GH/insulin-like growth factor 1 or because of the pituitary mass effects on gonadotropic cells, resulting in hypogonadism. Finally, although dehydroepiandrosterone (DHEA) and its sulfate have been implicated in a broad range of biological derangements, controlled trials have shown that DHEA administration is not useful for improving male sexual function. Conclusions. While the association between hyperprolactinemia and hypoactive sexual desire is well defined, more studies are needed to completely understand the role of other hormones in regulating male sexual functioning. Maggi M, Buvat J, Corona G, Guay A, and Torres LO. Hormonal causes of male sexual dysfunctions and their management (hyperprolactinemia, thyroid disorders, GH disorders, and DHEA). J Sex Med 2013;10:661677.
引用
收藏
页码:661 / 677
页数:17
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