Cure of hypogonadism after removal of prolactin-secreting adenomas in men.

Abstract

Two men with PRL-secreting pituitary adenomas and hypogonadism were studied before and repeatedly after transsphenoidal adenomectomy. Serum PRL levels were elevated (220 and 300 ng/ml), with no rise after perphenazine or TRH administration. Serum testosterone levels were low (180 and 155 ng/dl) but increased to 800 and 520 after hCG administration. Serum gonadotropin levels were low normal. Clomiphene treatment in patient 2 was not associated with an appreciable increase in FSH, LH, or testosterone. One patient had a normal sperm count, while the other was azospermic. One week after surgery, serum PRL levels were normal, yet serum testosterone remained low. A gradual and steady rise in the serum testosterone level was noted during the postoperative period, reaching normal levels in 8 and 10 weeks. Clinical improvement paralleled the steady rise in the serum testosterone level. Repeat clomiphene administration in patient 2 resulted in a normal rise in serum FSH, LH, and testosterone 13 weeks after surgery....