Do Most Men with Sexual Dysfunction Have High Prolactin? Does Cabergoline Help ?

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Nelson Vergel

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Reasons why prolactin may be important :

"Prolactin acts in a cytokine-like manner and as an important regulator of the immune system. Prolactin has important cell cycle related functions as a growth-, differentiating- and anti-apoptotic factor. As a growth factor binding to cytokine like receptors it has also profound influence on hematopoiesis, angiogenesis and is involved in the regulation of blood clotting through several pathways.

In summary, "more than 300 separate actions of PRL have been reported in various vertebrates, including effects on water and salt balance, growth and development, endocrinology and metabolism, brain and behavior, reproduction, and immune regulation and protection
It stimulates the mammary glands to produce milk (lactation): Increased serum concentrations of prolactin during pregnancycause enlargement of the mammary glands of the breasts and prepare for the production of milk. Milk production normally starts when the levels of progesterone fall by the end of pregnancy and a suckling stimulus is present. Sometimes, newborn babies (males as well as females) secrete a milky substance from their nipples known as witch's milk. This is in part caused by maternal prolactin and other hormones.


Prolactin provides the body with sexual gratification after sexual acts: The hormone counteracts the effect of dopamine, which is responsible for sexual arousal. This is thought to cause the sexual refractory period (the time it takes to recover after an orgasm to be able to have sex again). The amount of prolactin can be an indicator for the amount of sexual satisfaction and relaxation. Unusually high amounts are suspected to be responsible for impotence and loss of libido (see hyperprolactinemia symptoms).
Highly elevated levels of prolactin decrease the levels of sex hormones — estrogen in women and testosterone in men." Ref

No one has studied the effect of lowering prolactin or interfering with prolactin receptors on long term immune system function, so do not manipulate your prolactin unless you talk to your physician.


Effects of acute prolactin manipulation on sexual drive and function in males


Protirelin (a prolactin inducing drug) was provided via IV to some men and cabergoline was provided to others to induce low prolactin.
Administration of cabergoline decreased prolactin levels and significantly enhanced all parameters of sexual drive (P<0.05), function (P<0.01) and positive perception of the refractory period (P<0.01). Administration of protirelin increased prolactin concentrations and produced small, but not significant reductions of sexual parameters. The sexual effects observed from cabergoline were completely abrogated by coadministration of protirelin. Click here for study


Most Men with Sexual Dysfunction Do Not Have High Prolactin

In this study, men with sexual dysfunction where evaluated for Mild hyperprolactinemia (MHPRL; PRL levels of 420&#8211;735 mU/L or 20&#8211;35 ng/mL) and severe hyperprolactinemia (SHPRL, PRL levels >735 mU/L, 35 ng/mL). MHPRL and SHPRL were found in 69 (3.3%) and in 32 (1.5%) patients, respectively. Mean age and the prevalence of gynecomastia were similar in the two groups and in subjects with normal prolactin values. MHPRL was not confirmed in almost one-half of the patients after repetitive venous sampling. Hyperprolactinemia was associated with the current use of antidepressants, antipsychotic drugs, and benzamides. SHPRL was also associated with hypoactive sexual desire (HSD), elevated thyrotropin (TSH), and hypogonadism. The association between HSD and SHPRL was confirmed after adjustment for testosterone and TSH levels, and use of psychotropic drugs (hazard ratio
= 8.60[3.85&#8211;19.23]; P < 0.0001). In a 6-month follow-up of patients with SHPRL, testosterone levels and sexual desire were significantly improved by the treatment. Click here for study.


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