What are the effects of high serum prolactin in males

Elevated serum prolactin in males may affect sexual function, fertility, and metabolic health, mainly related to pituitary tumors, drug side effects, hypothyroidism, chronic kidney disease, or physiological factors.

1. Sexual dysfunction:

High prolactin can inhibit testosterone secretion, leading to decreased libido and erectile dysfunction. Some patients may experience breast development or galactorrhea. Mild elevation can be treated with dopamine receptor agonists such as bromocriptine, while severe cases require screening for pituitary lesions.

2. Decreased fertility:

Excessive prolactin can interfere with the hypothalamic pituitary gonadal axis and inhibit sperm production. Semen analysis often shows a decrease in sperm count or vitality. When accompanied by testicular atrophy, combined endocrine therapy and assisted reproductive technology intervention may be necessary.

3. Risk of metabolic disorders:

Long term high prolactin status is associated with insulin resistance and dyslipidemia, increasing the risk of cardiovascular disease. Patients may experience central obesity or impaired glucose tolerance, and it is recommended to regularly monitor blood glucose and lipid levels.

4. Pituitary tumors may:

Prolactin tumors are a common cause, and tumor compression can cause headaches and visual impairment. Magnetic resonance imaging can clearly determine tumor size. For microadenomas, drug treatment is preferred, while for macroadenomas, transsphenoidal surgery should be considered for resection.

5. Drug interference:

Antidepressants such as paroxetine and gastric medications such as ranitidine may temporarily increase prolactin levels. Follow up 2-4 weeks after discontinuation of medication, if there are persistent abnormalities, further examination of hypothalamic pituitary function is required.

It is recommended that men with hyperprolactinemia maintain a regular daily routine and avoid high-fat diets and alcohol intake. Moderate exercise helps regulate endocrine balance, and low-intensity exercises such as yoga or swimming are more suitable. Self check breast changes every month, and seek medical attention immediately if persistent headaches or visual changes occur. It is recommended to check serum prolactin and testosterone levels every 3-6 months during the review period, and to cooperate with pituitary imaging follow-up during medication adjustment.