Skip to main content

Advertisement

SpringerLink
Log in

A neutral effect of testosterone therapy on macroprolactin content in men with macroprolactinemia and late-onset hypogonadism

  • Original Research Article
  • Published:
Pharmacological Reports Aims and scope Submit manuscript

Abstract

Background

In the light of recent studies, macroprolactinemia seems to occur much more frequently than previously thought. In women, oral contraceptive pills exhibit a stimulatory effect on macroprolactin production. No previous study has investigated macroprolactin levels in androgen-treated hypogonadal men.

Methods

We studied 10 men with isolated macroprolactinemia and 14 men with normal prolactin levels who because of late-onset hypogonadism were treated with intramuscular testosterone enanthate. Serum prolactin, macroprolactin content, serum testosterone and gonadotropin levels were assessed at baseline and after 4 months of therapy.

Results

Although baseline levels of testosterone and gonadotropins were similar in men with and without macroprolactinemia, clinical symptoms were more severe in patients with elevated big-big prolactin levels. As expected, testosterone treatment increased serum testosterone, slightly reduced serum gonadotropins, as well as improved clinical condition in both patients with and without macroprolactinemia, with no difference between the groups. However, testosterone therapy did not affect serum prolactin and macroprolactin content, even after replacing intramuscular testosterone enanthate with oral testosterone undecanoate.

Conclusions

Our results suggest a negligible effect of testosterone replacement on macroprolactin levels in macroprolactinemic men with late-onset hypogonadism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ADAM:

androgen deficiency in aging male

FSH:

follicle-stimulating hormone

Ig:

immunoglobulin

LH:

luteinizing hormone

LOH:

late-onset hypogonadism

SD:

standard deviation

References

  1. Hattori N, Ishihara T, Saiki Y. Macroprolactinemia prevalence and aetiologies in a large group of hospital workers. Clin Endocrinol (Oxf) 2009;71:702–8.

    Article  Google Scholar 

  2. Kasum M, Oreskovic S, Zec I, Jezek D, Tomic V, Gall V, et al. Macroprolactinemia: new insights in hyperprolactinemia. Biochem Med (Zagreb) 2012;22:171–9.

    Article  CAS  Google Scholar 

  3. Kasum M, Pavičić-Baldani D, Stanić P, Orešković S, Sarić JM, Blajić J, Juras J. Importance of macroprolactinemia in hyperprolactinemia. Eur J Obstet Gynecol Reprod Biol 2014;183:28–32.

    Article  CAS  Google Scholar 

  4. Schiettecatte J, van Opdenbosch A, Anckaert E, de Schepper J, Poppe K, Velkeniers B, et al. Immunoprecipitation for rapid detection of macroprolactin in the form of prolactin-immunoglobulin complexes. Clin Chem 2005;51: 1746–8.

    Article  CAS  Google Scholar 

  5. Fahie-Wilson MN, John R, Ellis AR. Macroprolactin; high molecular mass forms of circulating prolactin. Ann Clin Biochem 2005;42(Pt 3):175–92.

    Article  CAS  Google Scholar 

  6. Fahie-Wilson M, Smith TP. Determination of prolactin: the macroprolactin problem. Best Pract Res Clin Endocrinol Metab 2013;27:725–42.

    Article  CAS  Google Scholar 

  7. McCudden CR, Sharpless JL, Grenache DG. Comparison of multiple methods for identification of hyperprolactinemia in the presence of macroprolactin. Clin Chim Acta 2010;411:155–60.

    Article  CAS  Google Scholar 

  8. Yuen YP, Lai JP, Au KM, Chan AY, Mak TW. Macroprolactin — a cause of pseudohyperprolactinaemia. Hong Kong Med J 2003;9:119–21.

    CAS  PubMed  Google Scholar 

  9. Olukoga AO. Macroprolactinemia is clinically important. J Clin Endocrinol Metab 2002;87:4833–4.

    Article  CAS  Google Scholar 

  10. Gibney J, Smith TP, McKenna TJ. Clinical relevance of macroprolactin. Clin Endocrinol (Oxf) 2005;62:633–43.

    Article  CAS  Google Scholar 

  11. Bjoro T, Makrid L, Wergerland R, Turter A, Kvistborg A, Sand T. Frequency of hyperprolactinemia due to large molecular weight prolactin (150–170 kD PRL). Scand J Clin Lab Invest 1995;55:139–47.

    Article  CAS  Google Scholar 

  12. Alfonso A, Rieniets KI, Vigersky RA. Incidence and clinical significance of elevated macroprolactin levels in patients with hyperprolactinemia. Endocr Pract 2006;12:275–80.

    Article  Google Scholar 

  13. Lu CC, Hsieh CJ. The importance of measuring macroprolactin in the differential diagnosis of hyperprolactinemic patients. Kaohsiung J Med Sci 2012;28:94–9.

    Article  Google Scholar 

  14. Vilar L, Naves LA, Freitas MC, Lima M, Canadas V, Albuquerque JL, et al. Clinical and laboratory features greatly overlap in patients with macroprolactinemia or monomeric hyperprolactinemia. Minerva Endocrinol 2007;32:79–86.

    CAS  PubMed  Google Scholar 

  15. Vallette-Kasic S, Morange-Ramos I, Selim A, Gunz G, Morange S, et al. Macroprolactinemia revisited: a study on 106 patients. J Clin Endocrinol Metab 2002;87:581–8.

    Article  CAS  Google Scholar 

  16. Nieschlag E, Swerdloff R, Behre HM, Gooren LJ, Kaufman JM, Legros JJ, et al. Investigation, treatment and monitoring of late-onset hypogonadism in males. Aging Male 2005;8:56–8.

    Article  CAS  Google Scholar 

  17. Huhtaniemi I. Late-onset hypogonadism: current concepts and controversies of pathogenesis, diagnosis and treatment. Asian J Androl 2014;16: 192–202.

    Article  Google Scholar 

  18. Basaria S. Reproductive aging in men. Endocrinol Metab Clin North Am 2013;42:255–70.

    Article  Google Scholar 

  19. Corona G, Rastrelli G, Maggi M. Diagnosis and treatment of late-onset hypogonadism: systematic review and meta-analysis of TRT outcomes. Best Pract Res Clin Endocrinol Metab 2013;27:557–79.

    Article  CAS  Google Scholar 

  20. Krysiak R, Kowalska B, Szkrobka W, Okopien B. The effect of oral contraception on macroprolactin levels in women with macroprolactinemia: a pilot study. Pharmacol Rep 2015 (in press).

  21. Bernie AM, Scovell JM, Ramasamy R. Comparison of questionnaires used for screening and symptom identification in hypogonadal men. Aging Male 2014;17:195–8.

    Article  Google Scholar 

  22. Mounier C, Trouillas J, Claustrat B, Duthel R, Estour B. Macroprolactinaemia associated with prolactin adenoma. Hum Reprod 2003;18:853–7.

    Article  CAS  Google Scholar 

  23. Tamer G, Telci A, Mert M, Uzum AK, Aral F, Tanakol R, et al. Prevalence of pituitary adenomas in macroprolactinemic patients may be higher than it is presumed. Endocrine 2012;41:138–43.

    Article  CAS  Google Scholar 

  24. Köhn FM, Schill WB. A new oral testosterone undecanoate formulation. World J Urol 2003;21:311–5.

    Article  Google Scholar 

  25. Christin-Maître S, Delemer B, Touraine P, Young J. Prolactinoma and estrogens: pregnancy, contraception and hormonal replacement therapy. Ann Endocrinol (Paris) 2007;68:106–12.

    Article  Google Scholar 

  26. Hattori N, Adachi T, Ishihara T, Shimatsu A. The natural history of macroprolactinaemia. Eur J Endocrinol 2012;166:625–9.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland

    Robert Krysiak, Beata Kowalska, Witold Szkróbka & Bogusław Okopień

  2. Department of Endocrinology, Provincial Hospital, Opole, Poland

    Beata Kowalska

Authors
  1. Robert Krysiak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Beata Kowalska
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Witold Szkróbka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bogusław Okopień
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert Krysiak.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Krysiak, R., Kowalska, B., Szkróbka, W. et al. A neutral effect of testosterone therapy on macroprolactin content in men with macroprolactinemia and late-onset hypogonadism. Pharmacol. Rep 68, 139–143 (2016). https://doi.org/10.1016/j.pharep.2015.08.003

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1016/j.pharep.2015.08.003

Keywords

Search

Navigation