Low Prolactin Is Associated with Sexual Dysfunction and Psychological or Metabolic Disturbances in Middle-Aged and Elderly Men: The European Male Aging Study (EMAS)
Giovanni Corona MD
Sexual Medicine and Andrology Unit Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy
Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Bologna, Italy
Search for more papers by this authorFrederick C. Wu MD
Department of Endocrinology, Manchester Royal Infirmary, The University of Manchester, Manchester, UK
Search for more papers by this authorGiulia Rastrelli MD
Sexual Medicine and Andrology Unit Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy
Search for more papers by this authorDavid M. Lee PhD
Epidemiology Unit, The University of Manchester, Manchester, UK
Search for more papers by this authorGianni Forti MD
Endocrinology Unit Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy
Search for more papers by this authorDaryl B. O'Connor PhD
Institute of Psychological Sciences, University of Leeds, Leeds, UK
Search for more papers by this authorTerence W. O'Neill MD
Epidemiology Unit, The University of Manchester, Manchester, UK
Search for more papers by this authorNeil Pendleton MD
Clinical Gerontology, The University of Manchester, Hope Hospital, Salford, UK
Search for more papers by this authorGyorgy Bartfai MD
Gynaecology and Andrology, Albert Szent-Gyorgy Medical University, Szeged, Hungary
Search for more papers by this authorSteven Boonen MD
Division of Gerontology and Geriatrics & Centre for Musculoskeletal Research, Department of Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
Search for more papers by this authorFelipe F. Casanueva MD
Department of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain
CIBER de Fisiopatología Obesidad y Nutricion (CB06/03), Instituto Salud Carlos III, Santiago de Compostela, Spain
Search for more papers by this authorJoseph D. Finn BSc
Epidemiology Unit, The University of Manchester, Manchester, UK
Search for more papers by this authorIlpo T. Huhtaniemi MD
Department of Reproductive Biology, Imperial College London, Hammersmith Campus, London, UK
Search for more papers by this authorKrzysztof Kula MD
Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
Search for more papers by this authorMargus Punab MD
Andrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia
Search for more papers by this authorDirk Vanderschueren MD
Department of Andrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium
Search for more papers by this authorMartin K. Rutter MD
Cardiovascular Research Group, School of Biomedicine, The University of Manchester, Manchester, UK
Search for more papers by this authorMario Maggi MD
Sexual Medicine and Andrology Unit Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy
Search for more papers by this authorEMAS Study Group
The members of the European Male Aging Study (EMAS) group are listed in Appendix A.Search for more papers by this authorGiovanni Corona MD
Sexual Medicine and Andrology Unit Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy
Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Bologna, Italy
Search for more papers by this authorFrederick C. Wu MD
Department of Endocrinology, Manchester Royal Infirmary, The University of Manchester, Manchester, UK
Search for more papers by this authorGiulia Rastrelli MD
Sexual Medicine and Andrology Unit Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy
Search for more papers by this authorDavid M. Lee PhD
Epidemiology Unit, The University of Manchester, Manchester, UK
Search for more papers by this authorGianni Forti MD
Endocrinology Unit Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy
Search for more papers by this authorDaryl B. O'Connor PhD
Institute of Psychological Sciences, University of Leeds, Leeds, UK
Search for more papers by this authorTerence W. O'Neill MD
Epidemiology Unit, The University of Manchester, Manchester, UK
Search for more papers by this authorNeil Pendleton MD
Clinical Gerontology, The University of Manchester, Hope Hospital, Salford, UK
Search for more papers by this authorGyorgy Bartfai MD
Gynaecology and Andrology, Albert Szent-Gyorgy Medical University, Szeged, Hungary
Search for more papers by this authorSteven Boonen MD
Division of Gerontology and Geriatrics & Centre for Musculoskeletal Research, Department of Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
Search for more papers by this authorFelipe F. Casanueva MD
Department of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain
CIBER de Fisiopatología Obesidad y Nutricion (CB06/03), Instituto Salud Carlos III, Santiago de Compostela, Spain
Search for more papers by this authorJoseph D. Finn BSc
Epidemiology Unit, The University of Manchester, Manchester, UK
Search for more papers by this authorIlpo T. Huhtaniemi MD
Department of Reproductive Biology, Imperial College London, Hammersmith Campus, London, UK
Search for more papers by this authorKrzysztof Kula MD
Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
Search for more papers by this authorMargus Punab MD
Andrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia
Search for more papers by this authorDirk Vanderschueren MD
Department of Andrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium
Search for more papers by this authorMartin K. Rutter MD
Cardiovascular Research Group, School of Biomedicine, The University of Manchester, Manchester, UK
Search for more papers by this authorMario Maggi MD
Sexual Medicine and Andrology Unit Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy
Search for more papers by this authorEMAS Study Group
The members of the European Male Aging Study (EMAS) group are listed in Appendix A.Search for more papers by this authorAbstract
Introduction
We previously reported that in male patients consulting for sexual dysfunction, low prolactin (PRL) levels were associated with metabolic syndrome (MetS), arteriogenic erectile dysfunction, and incident major cardiovascular events.
Aim
The aim of this study is to assess the clinical associations of PRL levels in the European Male Ageing Study (EMAS).
Methods
EMAS is a prospective, observational cohort of community-dwelling men aged 40–79 years old (mean age 60 ± 11 years old). PRL was available for 2,948 men.
Main Outcome Measures
Different parameters were evaluated including the Short Form-36 questionnaire, Becks Depression Inventory, the Adverse Life Events Scale, the Physical Activity Scale for the Elderly, and the EMAS sexual function questionnaire (EMAS-SFQ).
Results
After the adjustment for confounders, PRL levels were inversely related with worsening of sexual function as compared with the previous year, as derived from change in sexual functioning domain of the EMAS-SFQ (adj. r = −0.043; P = 0.029). The strongest correlation (Wald = 6.840; P = 0.009) was observed between lower PRL levels and reduced enjoyment of orgasmic experiences. Furthermore, an inverse relationship between PRL levels and stressful life events or depressive symptoms was observed. Low PRL was also negatively associated with an unhealthy metabolic phenotype as well as with the MetS (Wald = 5.229; P = 0.022). In line with these data, low PRL was associated with a lower level of physical activity and feeling unhealthier.
Conclusions
Low PRL is related to several metabolic, psychological, and sexual unhealthy characteristics in European men. Checking PRL might be useful to stratify men for cardiovascular risk and to encourage appropriate lifestyle changes. Corona G, Wu FC, Rastrelli G, Lee DM, Forti G, O'Connor DB, O'Neill TW, Pendleton N, Bartfai G, Boonen S, Casanueva FF, Finn JD, Huhtaniemi IT, Kula K, Punab M, Vanderschueren D, Rutter MK, Maggi M, and the EMAS Study Group. Low prolactin is associated with sexual dysfunction and psychological or metabolic disturbances in middle aged and elderly men: The European Male Aging Study (EMAS). J Sex Med 2014;11:240–253.
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