Endocrine Abstracts

This study evaluated the effects of the long treatment with cabergoline on seminal fluid parameters and sexual and gonadal function in hyperprolactinemic males. Eleven males with macroprolactinoma were treated with cabergoline at a dose of 1.5–2.5 mg a week for 6 months. All the patients suffered from libido impairment, reduced sexual potency, six had infertility. In three patients provocative bilateral galactorrhea was found.

Seminal fluid analysis, functional seminal tests, prolactin and testosterone concentrations and cerebrum magnetic resonance imaging were assessed before and after 6 months of cabergoline treatment. Baseline prolactin was 11530.7±222.6 mU/l. Baseline testosterone was 6.25±0.2 nmol/l. Before treatment, all patients had a low sperm count with oligoasthenospermia, reduced motility and rapid progression with an abnormal morphology and decreased viability, and a low number of erections.

After 6 months, serum PRL level was significantly reduced 682±16.6 mU/l (P<0.005). Testosterone level significantly increased to 19.8±0.04 nmol/L (P<0.002). After 6 months, a significant increase of sperm volume, number, total motility, rapid progression and normal morphology was recorded in patients treated with cabergoline. An increase in the number of erections during the first 3 months of treatment was noted. The number of erections was normalized after 6 months of treatment in all patients. Positive dynamics of the tumors volume was noted at 9 patients (81.2%) - adenoma has reduced. No dynamics observed in 2 men (18.8%). The bilateral galactorrhea in all three patients was not found.

The treatment with cabergoline normalized prolactin and testosterone levels, improving gonadal and sexual function and fertility in hyperprolactinaemic males and can be successfully used as primary therapy in men with large macroprolactinomas.