ED Endocrine Risk Factors: Hyperprolactinemia

Posted by Viagra Ed On July - 21 - 2012 Subscribe here

While hyperprolactinemia is often clinically associated with the existence of ED and hypoactive sexual desire, the prevalence and pathophysiology of this association are debated in the literature. The prevalence of hyperprolactinemia in men with ED or sexual dysfunction ranges from 1.5% to 10% in recent literature.

While several studies support the classic hypothesis that hyperprolactinemia causes ED through the suppression of GnRH, there is no consensus as of yet.
While severe hyperprolactinemia is a risk factor for sexual dysfunction, the role of moderate hyperprolactinemia in the pathophysiology of ED is unclear.

Thus, as with androgens, it is unclear if pathophysiologic findings from clinical studies and animal models are applicable to the clinical evaluation of ED. There is also evidence that prolactin may have a dichotomous role in erectile physiology. A recent study found that men with prolactin levels below 5 ng/mL had increased prevalence of arteriogenic ED, while men with hyperprolactinemia only had an increased prevalence of hypoactive sexual desire.

Thyroid Disease Both hypothyroid and hyperthyroid states are associated with ED, though the specific pathophysiology remains elusive. A recent study compared men with thyroid dysfunction to controls and reported that men with both hypothyroidism and hyperthyroidism had significantly increased the prevalence of and more severe ED. Overall, 79% of men with thyroid dysfunction had ED compared to 34% of controls. Both hyperthyroid and hypothyroid men had a prevalence of ED that exceeded the prevalence of ED in the control group. Additionally, both groups had significant response to treatment.

While extrapolation of specific physiologic mechanisms from clinical treatment is limited, these findings suggest that thyroid dysfunction acts at multiple sites to cause ED. There is some evidence that hypothyroidism causes a decline in both testosterone and steroid hormone binding globulin (SHBG).

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