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Hemoglobin decline as a signal for hyperprolactinemia onset prior to prolactinoma diagnosis in hypogonadal men

Hemoglobin decline as a signal for hyperprolactinemia onset prior to prolactinoma diagnosis in... INTRODUCTIONProlactinomas are uncommon among men, and present differently in males and females.1 Male prolactinomas are usually larger and more invasive.2 As hyperprolactinemia causes hypogonadotropic hypogonadism, women are aware of symptoms onset (as amenorrhea).3 On the other hand, male patients present with nonspecific symptoms of hypogonadism, such as decreased libido, erectile dysfunction, and weakness, usually with a slow and subtle onset.4 Visual symptoms, derived from tumor mass effect, are more common in male patients with macroprolactinoma and develop at a slow pace and aggravate unnoticed over long periods of time.5As with other secreting pituitary tumors, patients harboring prolactinomas suffer from a significant delay in diagnosis.6 Many studies have estimated the duration of the disease according to symptoms onset2,3,5,7–11; however, a latent period of asymptomatic (or unnoticed) hyperprolactinemia may be reasonably assumed. Moreover, the estimated duration of symptoms, reported by the patient, provides an inaccurate assessment, subject to recall bias. Relevant data were accumulated in the 1980s, when erectile problems lasted for many years until diagnosis.7 Patients were reluctant to share sexual difficulties, which were not an accepted part of public discourse during those years, or because there were no effective treatments for erectile dysfunction at the time. More recent studies http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Andrology Wiley

Hemoglobin decline as a signal for hyperprolactinemia onset prior to prolactinoma diagnosis in hypogonadal men

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Publisher
Wiley
Copyright
© 2023 American Society of Andrology and European Academy of Andrology.
ISSN
2047-2919
eISSN
2047-2927
DOI
10.1111/andr.13428
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Abstract

INTRODUCTIONProlactinomas are uncommon among men, and present differently in males and females.1 Male prolactinomas are usually larger and more invasive.2 As hyperprolactinemia causes hypogonadotropic hypogonadism, women are aware of symptoms onset (as amenorrhea).3 On the other hand, male patients present with nonspecific symptoms of hypogonadism, such as decreased libido, erectile dysfunction, and weakness, usually with a slow and subtle onset.4 Visual symptoms, derived from tumor mass effect, are more common in male patients with macroprolactinoma and develop at a slow pace and aggravate unnoticed over long periods of time.5As with other secreting pituitary tumors, patients harboring prolactinomas suffer from a significant delay in diagnosis.6 Many studies have estimated the duration of the disease according to symptoms onset2,3,5,7–11; however, a latent period of asymptomatic (or unnoticed) hyperprolactinemia may be reasonably assumed. Moreover, the estimated duration of symptoms, reported by the patient, provides an inaccurate assessment, subject to recall bias. Relevant data were accumulated in the 1980s, when erectile problems lasted for many years until diagnosis.7 Patients were reluctant to share sexual difficulties, which were not an accepted part of public discourse during those years, or because there were no effective treatments for erectile dysfunction at the time. More recent studies

Journal

Andrology – Wiley

Published: Mar 10, 2023

Keywords: anemia; hemoglobin; male; prolactin; prolactinoma

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