Commentary

Abstract

The frequency of decreased or absent libido/potency was studied in 65 males with tumors in the region of the sella turcica. The presence or absence of sexual dysfunction was correlated to the serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and prolactin; to the LH response to LH-releasing hormone (LH-RH); and to certain tumor characteristics. Seventy-six per cent of the patients had decreased or absent libido/potency. The corresponding figures for those with an intrasellar tumor and those with a large tumor with extention into the suprasellar region were 54% and 88%, respectively. Only 1 of 20 patients whose first symptom of a tumor was a decrease in libido or potency consulted a doctor because of this symptom. The serum levels of FSH and LH in the group of patients with decreased or absent libido/potency were within the normal range in 47% and 34%, respectively, but almost all of these patients had low serum levels of testosterone. The LH response to LH-RH was better related to the presence or absence of sexual dysfunction than was the basal LH level. There was no significant relationship between decreased or absent libido/potency and increased serum prolactin levels. A low serum testosterone level indicates an endocrine etiology of the sexual dysfunction. When combined with a normal or decreased level of gonadotropins, a primary disturbance of hypothalamic-pituitary function is probable.