背景:已发现低催乳素水平会损害性欲和唤醒,以及降低年轻女性的幸福感。
目的:本研究的目的是调查药物诱导的低泌乳素血症是否影响男性性功能和抑郁症状。
方法:研究人群包括三组中青年男性。由于先前的高催乳素血症,两组均接受多巴胺激动剂治疗,但目前的催乳素水平不同。<3ng/ml(n=12;组1)或在参考范围内(3-20ng/ml)(n=20;组2)。对照组(第3组)包括24名多巴胺激动剂初治的正常泌乳素血症男性。在研究期间,与研究开始前的剂量相比,第1组的多巴胺能药物剂量减少了25-50%.催乳素的循环水平,睾丸激素,免费计算睾丸激素,硫酸脱氢表雄酮,雌二醇和促性腺激素在纳入研究后和6个月后测定.此外,在研究的开始和结束时,所有男性纳入了评估性功能(IIEF-15)和抑郁症状(BDI-II)的完整问卷.
结果:第1组与第2组和第3组的性欲和勃起功能领域评分不同,和整体BDI-II得分。其特征还在于较低水平的总睾酮和计算的游离睾酮。减少药物剂量使性欲和勃起功能正常化,降低BDI-II评分,增加催乳素以及总睾酮和游离睾酮。第2组和第3组在性功能方面没有差异,抑郁症状或激素水平。
结论:获得的结果表明,患有多巴胺激动剂诱导的低泌乳素血症的男性的特征是性功能受损和健康下降。这些紊乱是催乳素水平低于正常的结果,似乎并不反映多巴胺激动剂的不良反应。
BACKGROUND: Low prolactin levels have been found to impair libido and arousal, as well as to reduce wellbeing in young women.
OBJECTIVE: The aim of this study was to investigate whether drug-induced hypoprolactinaemia affects male sexual function and depressive symptoms.
METHODS: The study population consisted of three groups of young and middle-aged men. Two groups were treated with dopamine agonists because of previous hyperprolactinaemia but differed in current prolactin levels, which were <3ng/ml (n=12; group 1) or within the reference range (3-20ng/ml) (n=20; group 2). The control group (group 3) included 24 dopamine agonist-naïve normoprolactinaemic men. During the study, doses of dopaminergic agents in group 1 were reduced by 25-50% compared to doses before the start of the study. Circulating levels of prolactin, testosterone, free calculated testosterone, dehydroepiandrosterone-sulphate, oestradiol and gonadotropins were measured upon enrolment in the study and six months later. Moreover, at the beginning and the end of the study, all men enrolled completed questionnaires assessing sexual functioning (IIEF-15) and depressive symptoms (BDI-II).
RESULTS: Group 1 differed from groups 2 and 3 in domain scores for sexual desire and erectile function, and in the overall BDI-II score. It was also characterised by lower levels of total testosterone and calculated free testosterone. Reduction of drug doses normalised sexual desire and erectile function, reduced BDI-II scores and increased prolactin as well as total and free calculated testosterone. Groups 2 and 3 did not differ from each other in sexual functioning, depressive symptoms or hormone levels.
CONCLUSIONS: The results obtained indicate that men with dopamine agonist-induced hypoprolactinaemia are characterised by impaired sexual functioning and reduced wellbeing. These disturbances are a consequence of subnormal prolactin levels and do not seem to reflect adverse effects of dopamine agonists.