[Effects of hyperprolactinemia on sexual and gonadal function in men, and the benefit of treating them with cabergoline for three months]

Physiologic levels of prolcatin play a vital role in sexual life in men. hyperprolactinemia, although rare in male individuals, can cause sexual and gonadal dysfunction which eventually inhibits all aspects of sexual behavior. In contrast to those conducted in women, there is only a limited number of trials conducted in men regarding the matter in question, and most of the clinical trials were carried out in hyperprolactinemic men with prolactinomas, while only few studies involved idiopathic hyperprolactinemic men. we conducted this trial which aimed at evaluating sexual function particularly libido and potency, seminal parameters, and related hormones in 20 subjects suffering from hyperprolactinemia, with prolactin levels at least double normal values, compared to 20 healthy men. We also investigated the benefits of treating those patients for three months with cabergoline. We found reduced libido as well as erectile dysfunction in all patients [100%], and blood analyses reported gonadal insufficiency in 5 patients [25%], asthenospermia in 11 [55%], as well as reduced sperm concentration and motility, although being within normal range, compared to control group. Treatment with cabergoline normalized prolactin levels, improved libido and potency significantly in all patients, and restored gonadal function in patients who complained from gonadal insufficiency at study entry. In conclusion, hyperprolactinemia interferes with some seminal parameters and sexual hormones. Treatment with cabergoline for three months could restore normal sexual function, as well as semen and blood parameters

Disfunção do eixo gonadotrófico em homens com infecção pelo HIV/Aids: [revisão] / Gonadotrophic axis dysfunction in men with HIV-infection/Aids: [review]

A disfunção do eixo gonadotrófico é frequentemente observada em pacientes infectados pelo HIV. A patogênese é multifatorial e está relacionada à duração da infecção pelo HIV, aos efeitos citopáticos diretos do vírus, ao uso de drogas gonadotóxicas, às infecções oportunistas, às neoplasias, à desnutrição, entre outros fatores. Em homens, a redução dos níveis de testosterona está associada à perda de massa e de força muscular, à redução da densidade mineral óssea, à lipodistrofia, à depressão, à astenia, à fadiga e à disfunção sexual. Em pacientes infectados pelo HIV com hipogonadismo, inúmeros estudos têm comprovado os efeitos benéficos da reposição de testosterona sobre o perfil metabólico e a distribuição da gordura corporal, com aumento da massa corporal magra, além de promover melhora da qualidade de vida, reduzir a perda de massa óssea e reduzir os índices de depressão. Assim, esta revisão teve como objetivo trazer uma breve atualização sobre o presente tema, abordando dados epidemiológicos, mecanismos fisiopatológicos e estratégias terapêuticas para as principais anormalidades do eixo gonadotrófico masculino associadas à infecção pelo HIV e ao seu tratamento.

Gonadotrophic axis dysfunction is commonly observed in HIV-infected patients. The pathogenesis is multifactorial and related to duration of HIV infection, direct cytopathic effects of viruses, use of drugs, opportunistic infections, malignancies, and malnutrition, among other factors. In men, reduced levels of testosterone is associated with loss of muscle mass and strength, decreased bone mineral density, lipodystrophy, depression, asthenia, fatigue and sexual dysfunction. In HIV-infected patients with hypogonadism, numerous studies have shown the beneficial effects of testosterone replacement on the metabolic profile and distribution of body fat, with increased body mass weight, and promote better quality of life, reduce the bone mass loss and the rates of depression. Thus, this review aimed to present a brief update of epidemiologic data, pathophysiology aspects and treatment strategies for the major abnormalities of male gonadotrophic axis associated with HIV infection and its treatment.

Comparative studies on the possible therapeutic effect of a natural remedy and hypertensive drugs on hypertension-induced gonadal dysfunction in male rats

Several studies suggested the involvement of hypertension in the gonadal dysfunction, however the exact mechanisms of action remained to be clarified. The present study was conducted to investigate the effect of high salt diet-induced hypertension on the gonadal activity and the possible therapeutic effect of concurrent treatment with karkade, as natural antihypertensive plant and furosemide and losartan as hypertensive drugs in male adult albino rats. This was achieved by determining thyroid stimulating hormone [TSH], triiodothyronine [T3], tetraiodothyronine [T4] and free testosterone in blood serum of different treatments. Feeding of high-salt diet for one and half months significantly increased the systolic, diastolic and mean blood pressure as well as increased the levels of TSH, T3 and T4 and depressed level of free testosterone in comparison to control rats. Treatments with the antihypertensive drugs [furosemide and losartan] and karkade remarkably restored the normal blood pressure. Losartan treatment significantly regained the normal levels of TSH, T3, T4 and free testosterone. Combined treatment with either furosemide or karkade to hypertensive rats did not restore the normal levels of TSH, T3, T4 and free testosterone in comparison to control rats. In addition, individual treatment with furosemide and karkade to normotensive rats induced moderate decrease in the levels TSH, T3, T4 and free testosterone. The present study indicates that hypertension induced hormonal disorder and gonadal dysfunction. In addition, not all anti-hypertensive drugs are successful candidates for reversing gonadal dysfunction. The study conclude that although, the excessive use of natural antihypertensive remedy, karkade, can produce a beneficial effect on blood pressure, it might produce undesirable effect on the gonadal activity