Effects of chronic sulpiride-induced hyperprolactinemia on plasma testosterone and its responses to hCG in normal men (original) (raw)
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Induced hypoprolactinemia and testicular steroidogenesis in man
Journal of andrology
The effects of short-term hypoprolactinemia on the pituitary-gonadal axis were evaluated in a group of patients with untreated prostatic carcinoma. Each patient was studied prior to and during 7-day oral administrations of bromocriptine (2.5 mg q.i.d.). Serum LH, prolactin (PRL), androst-4-ene-3,17 dione (androstenedione), testosterone, and 5 alpha-androstane-3 alpha, 17 beta-diol (5 alpha-Diol) levels, as well as intra-testicular testosterone, dihydrotestosterone (DHT), 5 alpha-Diol and zinc (Zn) concentrations, were determined. Daily administration of bromocriptine caused a marked suppression of serum PRL (mean +/- SEM, 23.8 +/- 2.5 vs. 6.4 +/- 1.0 ng/ml) without concomitant changes in serum LH levels (mean +/- SEM, 8.3 +/- 1.6 vs. 8.9 +/- 2.1 ng/ml). Hypoprolactinemia induced a significant decrease (P less than 0.05) in the mean peripheral testosterone levels; but 5 alpha-Diol and androstenedione remained unchanged. However, in testicular tissues, bromocriptine treatment resulted...
Andrologia, 2009
Our purpose was to study the effects of long-term salazopyrine treatment on male fertility. Seven patients, 2 1-37 years old, who had been treated for ulcerative colitis with 3 g/ day of salazopyrine for more than 6 months, were examined. All their semen samples showed abnormal sperm motility (17% f. 9.3) and abnormal morphology (36.3% k 14.4) with the predominance of large-headed spermatozoa. The endocrine picture and pituitary reserve were evaluated by GnRH and TRH tests. The basal values of testosterone were lower than the normal in our laboratory (> 3 ng/ml) and significantly lower (2.4 k 0.7 ng/ml, p < 0.025) than in the control group (fertile men). LH was significantly higher (9 k 2 mIU/ml, p < 0.005) but still within the limits of normal. The responses of FSH and LH to GnRH and of PRL to TRH were normal. The mechanisms by which salazopyrine may affect fertility are discussed. Abnormale Samenqualitat und herabgesetztes Serum-Testosteron bei Mannern mit entzundlicher Darmerkrankung (Colitis ulcerosa), die fur einen Iangeren Zeitraum mit Sulfasalazin behandelt wurden Zusammenfassung: Bei 7 Mannern im Alter von 21-37 Jahren mit einer Colitis ulcerosa, die langer als 6 Monate mit 3 g Sulfasalazin tgl. behandelt wurden, kontrollierten die Autoren den EinfluD dieser Medikation auf die Samenqualitat. In allen F d e n ergab sich eine Herabsetzung der Motilitat (17% k 9,3) und der Normalmorphologie (36,3% ? 14,4) mit Pradominanz groi3er Kopfe bei den Spermatozoen. Mittels GnRH-und TRH-Tests wurden das endokrine Profil und die Hypophysenreserve untersucht. Fiir das basale Testosteron ergaben sich niedrigere Werte gegeniiber dem Normalen und signifkant niedrigere Werte gegeniiber einer Kontrollgruppe von fertilen Mannern. LH war signifkant hoher, allerdings noch im Normbereich. Die Reaktion von FSH und LH auf GnRH und von Prolaktin auf TRH war normal. Die verschiedenen Mechanismen von Sulfasalazin auf die Spermatogenese werden diskutiert; in diesem Zusammenhang wird an einen direkten toxischen Einflui3 des Metaboliten Sulfapyridin bzw. Sulfasalazin gedacht. Auch eine kompetetive Hemmung des Folinsiiure-Transports durch die Darmwand ist denkbar. Schlieislich wird ein Einflui3 auf die
Semen Characteristics and Serum and Seminal Plasma Hormones in Drug-Induced Hyperprolactinaemia
Systems Biology in Reproductive Medicine, 1982
Semen volume, density, motility, viability, and morphology of spermatozoa, and serum and seminal plasma levels of the hormones FSH, LH, prolactin, progesterone, 17-a-hydroxyprogesterone, androstenedione, testosterone, dihidrotestosterone, and estradiol 17-p have been measured in 22 men subjected to experimental hyperprolactinaemia by the simultaneous administration of the antidopaminergic drugs metoclopramide and sulpiride. Hyperprolactinaemia produces a decrease of semen volume and seminal quality. In hyperprolactinaemia, normozoospermic patients had an increase of serum androstenedione. In both norrno-and oligozoospermic groups, a decrease of serum testosterone was observed. Hyperprolactinaemia also causes an inhibition of the secretory activity of the accessory sexual glands of the reproductive tract, as well as either a decrease of 17-ketosteroid reductase or an increase of 17-a-hydroxysteroid dehydrogenase (enzymes that participate in the androstenedione-testosterone interconversions). This change appears to be more pronounced in' individuals with good seminal quality.
Özet Amaç: Hiperprolaktineminin semen parametrelerine olumsuz etkileri bilin-mektedir, ancak bu etki açık değildir. Bu çalışmamızda, hiperprolaktineminin semen parametrelerine etkilerini değerlendirmeyi amaçladık. Gereç ve Yön-tem: Çalışmamıza hastanemiz erkek infertilitesi polikliniğine başvuran 334 hasta dahil edildi. Hastaların prolaktin düzeyi ve semen analizi çalışıldı. Pro-laktin için sınır değer 20 ng/ml, sperm konsantrasyonu için 15x10 6 /ml, total motilite için %40, ileri motilite için %32, morfoloji için %4 kabul edildi. Bulgu-lar: Hastaların ortalama prolaktin, sperm konsantrasyonu, total motilite, ile-ri motilite değerleri sırasıyla 11,07 ng/ml, 26x106/ml, %42, %29'du. Prolak-tin düzeyleri ile semen parametrelerinin hiç birinde istatistiksel olarak anlam-lı derecede ilişki bulunmadı. Tartışma: Prolaktin düzeyi ile semen parametre-leri arasında anlamlı ilişki saptanmamış olsa da literatürdeki veriler ışığında sperm konsantrasyonu 10x10 6 /ml'nin altında olan hastalarda prolaktin sevi-yesinin çalışılmasını önermekteyiz. Abstract Aim: Hyperprolactinemia is known adverse effects on semen parameters but this effect is not clear. In this study, we aimed to evaluate the effects of hyperprolactinemia on semen parameters. Material and Method: The study comprised 334 patients who presented to the outpatient clinics for male infertility. Prolactin levels were measured and semen analysis was performed on all patients. The limit values for prolactin, sperm concentration and total motility, progressive motility, and morphology were determined to be 20 ng/ml, 15x10 6 /ml, 40%, 32%, and 4%, respectively. Results: Levels of mean prolactin, sperm concentration, total mortality, progressive motility values were 11.07 ng/ml, 26x10 6 /ml, 42%, and 29%. No significant differences were found in any of the semen parameters according to the prolactin levels (p>0.05). Discussion: Although no significant association between the pro-lactin level and semen parameters was detected, we suggest that prolactin levels should be tested in patients with a sperm concentration of less than 10x10 6 /ml in light of literature data.
Hyperprolactinemia in Men: Clinical and Biochemical Features and Response to Treatment
Endocrine, 2003
Hyperprolactinemia induces hypogonadism by inhibiting gonadotropin-releasing hormone pulsatile secretion and, consequently, follicle-stimulating hormone, luteinizing hormone, and testosterone pulsatility. This leads to spermatogenic arrest, impaired motility, and sperm quality and results in morphologic alterations of the testes similar to those observed in prepubertal testes. Men with hyperprolactinemia present more frequently with a macroadenoma than a microadenoma. Symptoms directly related to hypogonadism are prevalent. In men hypogonadism leads to impaired libido, erectile dysfunction, diminished ejaculate volume, and oligospermia. It is present in 16% of patients with erectile dysfunction and in approx 11% of men with oligospermia. Treatment with bromocriptine or cabergoline (CAB) is effective in men with prolactinomas, with a response that is in general comparable to treatment in women. Seminal fluid abnormalities rapidly improve with CAB treatment, while other dopaminergic compounds require longer periods of treatment. Moreover, to improve gonadal function in men, the integrity of the hypothalamic-pituitary-gonadal axis is necessary. New promising data indicate that a substantial proportion of patients with either micro-or macroprolactinoma do not present hyperprolactinemia after long-term withdrawal from CAB. Whether this corresponds to a definitive cure is still unknown, but treat-ment withdrawal should be attempted in patients achieving normalization of prolactin levels and disappearance of tumor mass to investigate this issue.
Acta medica portuguesa, 1980
Basal levels of prolactin (PRL) and estradiol (E 2 ) were studied in 10 adolescents with gynecomastia who were at stages II to IV of their sexual development. In 7 of the 10 patients, the hypophyseal response of PRL to the administration of sulpiride was assessed: 5 of the 7 received 25 mg i.m., and the remaining 50 mg. i.m. The 10 cases were compared with 12 control boys without gynecomastia matched for stage of sexual development. Five of the controls were given 25 mg of sulpiride i.m. and the other 50 mg. Basal PRL levels were the same in both groups. Sulpiride stimulates the secretion of PRL in boys with and without gynecomastia. However, a significantly increased circulating E 2 level was found in patients with gynecomastia.
RELATION OF hCG-STIMULATED STEROIDOGENESIS TO SERUM FSH, LH AND PROLACTIN IN MAN
Clinical Endocrinology, 1981
Nine adult healthy male volunteers were given a single intramuscular injection of 5000 iu of human chorionic gonadotrophin (hCG). Peripheral blood samples were collected up to 7 days after the injection, the sera were analysed for LH, FSH and prolactin and the results were related to changes in the concentrations of testosterone and oestradiol. Serum LH concentrations tended to decrease for 4 days after the hCG injection (to 65% of the 0 h value) but returned to the starting level during the 7-day observation period. FSH was suppressed throughout the experiment and correlated inversely with serum prolactin (r=-0.74, P<O.Ol). The first significant decrease was seen at 48 h and the minimum concentration (28 f 4%, SEM) at 7 days. Prolactin levels changed only slightly during the first 48 h after the injection but increased thereafter, being significantly elevated at 4 days, and reached a maximum (1 83 ? 22%) at 6 days after hCG adminstration, coinciding with the late phase of the testosterone response to hCG. Between testosterone and prolactin a positive correlation (r = 0.70. P < 0.01) was found during hCG
Endocrinology, 1977
The influence on the ultrastructure of pinealocytes of long-term hyperprolactinemia caused by ectopic pituitary transplants and of suppression of prolactin release by bromocriptine was examined morphometrically in male rats. Hyperprolactinemia resulted in an increase in the relative volumes of granular endoplasmic reticulum, vacuoles containing a flocculent material, mitochondria, and lipid droplets. Treatment of grafted rats with bromocriptine reversed the effects of hyperprolactinemia. However, bromocriptine had no apparent influence on the pinealocytes of intact rats. The effects of hyperprolactinemia on the ependymallike secretory process in the pinealocyte were especially pronounced.
The Effect of Hyperprolactinemia on Semen Parameters
Annals of Clinical and Analytical Medicine, 2016
Amaç: Hiperprolaktineminin semen parametrelerine olumsuz etkileri bilinmektedir, ancak bu etki açık değildir. Bu çalışmamızda, hiperprolaktineminin semen parametrelerine etkilerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmamıza hastanemiz erkek infertilitesi polikliniğine başvuran 334 hasta dahil edildi. Hastaların prolaktin düzeyi ve semen analizi çalışıldı. Prolaktin için sınır değer 20 ng/ml, sperm konsantrasyonu için 15x10 6 /ml, total motilite için %40, ileri motilite için %32, morfoloji için %4 kabul edildi. Bulgular: Hastaların ortalama prolaktin, sperm konsantrasyonu, total motilite, ileri motilite değerleri sırasıyla 11,07 ng/ml, 26x106/ml, %42, %29'du. Prolaktin düzeyleri ile semen parametrelerinin hiç birinde istatistiksel olarak anlamlı derecede ilişki bulunmadı. Tartışma: Prolaktin düzeyi ile semen parametreleri arasında anlamlı ilişki saptanmamış olsa da literatürdeki veriler ışığında sperm konsantrasyonu 10x10 6 /ml'nin altında olan hastalarda prolaktin seviyesinin çalışılmasını önermekteyiz.