Kromě hypogonadizmu jsou s mužskou sexuální dysfunkcí spojena i další endokrinní onemocnění. V našem článku se zabýváme úlohou hypofyzárního hormonu prolaktinu při mužských sexuálních dysfunkcích, zvláště pak při erektilní dysfunkci. Erektilní dysfunkce je u mužů s hyperprolaktinémií častá. Léčba této primární příčiny může ovlivnit normální erektilní funkci. V souboru našich pacientů došlo po léčbě hyperprolaktinémie (medikamentózní i operační) k normalizaci hladiny prolaktinu u všech léčených pacientů. Erektilní dysfunkce byla u všech mužů léčena některým typem inhibitoru 5 fosfodiesterázy – tedy sildenafilem, tadalafilem, vardenafilem, avanafilem. Po zaléčení primární příčiny erektilní dysfunkce pak došlo i ke zlepšení IIEF-5 (International Index of Erectile Function) skóre, a tedy i erektilní funkce všech našich pacientů.

In addition to hypogonadism, other endocrine dis­eases are associated with male sexual dysfunction. In this article, we review the role of the pituitary hormone prolactin in male sexual dysfunction, and in particular in erectile dysfunction. Erectile dysfunction is common in men with hyperprolactinemia. Treatment of this primary cause may affect normal erectile function. In our patient cohort, after treatment of hyperprolactinemia (medical and surgical), prolactin levels normalized in all treated patients. Erectile dysfunction in all men was treated with some type of phosphodiesterase 5 inhibitor - i.e. sildenafil, tadalafil, vardenafil, avanafil. After the treatment of the primary cause of erectile dysfunction, there was then also an improvement in IIEF-5 (International Index of Erectile Function) score and therefore erectile function in all our patients.

• MeSH
• Erectile Dysfunction etiology   therapy   MeSH
• Hyperprolactinemia * diagnosis   etiology   drug therapy   complications   MeSH
• Phosphodiesterase 5 Inhibitors therapeutic use   MeSH
• Humans MeSH
• Pituitary Neoplasms surgery   diagnosis   complications   MeSH
• Prolactin blood   MeSH
• Prolactinoma MeSH
• Check Tag
• Humans MeSH

Úvod: Prolaktinóm je adenóm hypofýzy, ktorý secernuje prolaktín. Tvorí približne 40 % všetkých adenómov hypofýzy. Podľa veľkosti sa delí na mikro, makro a obrovský prolaktinóm. U žien sa prejavuje poruchou menštruačného cyklu až amenorrheou, galaktorrheou, nárastom hmotnosti, u oboch pohlaví ako sterilita, hypogonadizmus, znížené libido a depresia. Pri makroadenóme sa pridávajú aj príznaky z útlaku okolitých štruktúr ako bolesť hlavy, vomitus, dolný chiazmatický syndróm a oftalmoplégia. Poruchy zorného poľa z útlaku chiazmy spôsobuje tumor o veľkosti minimálne 10–15 mm so supraselárnym šírením, ktorý preráža diaphragma sellae. Obrovské prolaktinómy s rozmerom nad 40 mm sú zriedkavé a tvoria 1–5% všetkých prolaktinómov. Kazuistika: Formou článku prezentujeme prípad 38-ročnej odídenkyne z Ukrajiny s pokročilým dolným chiazmatickým syndrómom pri obrovskom prolaktinóme. Nádor utláča chiazmu zdola, infiltruje aj ľavostranný sinus cavernosus a spôsobuje ľavostrannú amaurózu a pravostrannú temporálnu hemianopsiu. Záver: Dolný chiazmatický syndróm sa vyznačuje bitemporálnou hemianopsiou, poklesom centrálnej zrakovej ostrosti, bilaterálnou descendentnou atrofiou optického nervu tvaru motýlika a hemianoptickou ztuhlosťou zreníc. Makroprolaktinómy sa vyskytujú častejšie u mužov ako u žien. Ich diagnostika je často oneskorená, pravdepodobne preto, že symptómy hyperprolaktinémie sú u mužov menej zjavné, zatiaľ čo ženy majú tendenciu prezentovať sa skôr v dôsledku nepravidelností menštruačného cyklu. Prolaktinómy majú zvyčajne dobrú prognózu. Je dostupná efektívna medikamentózna liečba dopaminergnými agonistami. Poznať celkové príznaky prolaktinómu a cielene ich skúmať pri odbere anamnézy nám uľahčí diagnostiku pri podozrení na kompresívne lézie optickej chiazmy.

Aim: Prolactinoma is a pituitary adenoma that secretes prolactin. Approximately 40% of all pituitary adenomas are prolactinomas. According to size, they are divided into micro, macro and giant prolactinomas. In women, prolactinomas cause irregularities of the menstrual cycle such as amenorrhea, galactorrhea, weight gain, in both sexes they cause sterility, hypogonadism, decreased libido and depression. In macroadenomas, symptoms due to the compression of the surrounding structures are also manifested, such as headache, vomiting, lower chiasmatic syndrome and ophthalmoplegia. Loss of the visual field due to compression of the optic chiasm is caused by a tumor larger than 10–15 mm with suprasellar spreading, which breaks through the diaphragma sellae. Giant prolactinomas are larger than 40 mm and make up 1–5% of all prolactinomas. Case report: In this article I present the case of a 38-year-old woman from Ukraine with advanced chiasmatic syndrome caused by a giant prolactinoma. The tumor is infiltrating the left cavernous sinus, causing left-sided amaurosis and right-sided temporal hemianopsia. Conclusion: Inferior chiasmatic syndrome is characterized by bitemporal hemianopsia, a deterioration of visual acuity, bilateral bow-tie descendent atrophy of the optic nerve disc, and hemianopic rigidity of the pupils. Macroprolactinomas occur more frequently in men than in women. The diagnosis is often delayed, probably because the symptoms of hyperprolactinemia are less obvious in men, while women tend to present earlier due to menstrual cycle irregularities. Prolactinomas usually have a good prognosis. Effective medical treatment with dopamine agonists is available. Knowledge of the prolactinoma symptoms could help the diagnosis of compressive lesions of the optic chiasm.

• MeSH
• Adult MeSH
• Humans MeSH
• Vision Disorders etiology   MeSH
• Prolactin analysis   MeSH
• Prolactinoma * diagnosis   complications   physiopathology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Migraine is a severe neurovascular disorder of which the pathophysiology is not yet fully understood. Besides the role of inflammatory mediators that interact with the trigeminovascular system, cyclic fluctuations in sex steroid hormones are involved in the sex dimorphism of migraine attacks. In addition, the pituitary-derived hormone prolactin and the hypothalamic neuropeptide oxytocin have been reported to play a modulating role in migraine and contribute to its sex-dependent differences. The current narrative review explores the relationship between these two hormones and the pathophysiology of migraine. We describe the physiological role of prolactin and oxytocin, its relationship to migraine and pain, and potential therapies targeting these hormones or their receptors.In summary, oxytocin and prolactin are involved in nociception in opposite ways. Both operate at peripheral and central levels, however, prolactin has a pronociceptive effect, while oxytocin appears to have an antinociceptive effect. Therefore, migraine treatment targeting prolactin should aim to block its effects using prolactin receptor antagonists or monoclonal antibodies specifically acting at migraine-pain related structures. This action should be local in order to avoid a decrease in prolactin levels throughout the body and associated adverse effects. In contrast, treatment targeting oxytocin should enhance its signalling and antinociceptive effects, for example using intranasal administration of oxytocin, or possibly other oxytocin receptor agonists. Interestingly, the prolactin receptor and oxytocin receptor are co-localized with estrogen receptors as well as calcitonin gene-related peptide and its receptor, providing a positive perspective on the possibilities for an adequate pharmacological treatment of these nociceptive pathways. Nevertheless, many questions remain to be answered. More particularly, there is insufficient data on the role of sex hormones in men and the correct dosing according to sex differences, hormonal changes and comorbidities. The above remains a major challenge for future development.

• MeSH
• Analgesics therapeutic use   MeSH
• Pain drug therapy   MeSH
• Humans MeSH
• Migraine Disorders * MeSH
• Oxytocin * physiology   MeSH
• Gonadal Steroid Hormones MeSH
• Prolactin * physiology   MeSH
• Receptors, Oxytocin MeSH
• Receptors, Prolactin MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

• MeSH
• Dopamine Agonists pharmacology   therapeutic use   MeSH
• Hyperprolactinemia diagnosis   etiology   blood   metabolism   prevention & control   MeSH
• Humans MeSH
• Pituitary Neoplasms diagnosis   drug therapy   classification   MeSH
• Prolactin analysis   metabolism   adverse effects   MeSH
• Prolactinoma * diagnostic imaging   diagnosis   epidemiology   drug therapy   classification   MeSH
• Pregnant People MeSH
• Check Tag
• Humans MeSH
• Female MeSH
• Publication type
• Review MeSH

Delayed ejaculation belongs to the group of sexual disorders in men. The causes of delayed ejaculation or anejaculation are not exactly known. It is assumed that it can be caused by psychogenic or organic influences or their combinations. One of the causes of delayed ejaculation may be elevated prolactin levels, which may be increased by psychosocial stress, pituitary disorders or also treatment with selective serotonin reuptake inhibitors in the treatment of depression. We tested a selected group of 50 men who were diagnosed with a depressive disorder and whose antidepressant treatment lasted for at least 24 weeks. These patients reported long-term delayed ejaculation or, in some cases, anejaculation as comorbidity. The results showed significant Spearman's correlation between elevated prolactin levels and intravaginal ejaculation latency values (R = 0.45), as well as between Beck's Depression-II inventory and intravaginal ejaculation latency and latency values (R = 0.48).

• MeSH
• Depressive Disorder * MeSH
• Ejaculation MeSH
• Humans MeSH
• Premature Ejaculation * etiology   MeSH
• Prolactin MeSH
• Selective Serotonin Reuptake Inhibitors pharmacology   therapeutic use   MeSH
• Sexual Dysfunction, Physiological * etiology   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH

Prolaktinomy jsou nejčastější hormonálně aktivní adenomy hypofýzy. U žen je obvyklým příznakem onemocnění amenorea či jiná porucha menstruace. Diagnostika je založena na zjištění hyperprolaktinemie s verifikací adenomu v oblasti tureckého sedla pomocí magnetické rezonance. Ve většině případů má dobrý efekt samostatná farmakoterapie kabergolinem. Léčbu makroprolaktinomů je nutné individuálně zvažovat, uplatňuje se kombinace více modalit, například operace nebo ozáření gama nožem následované farmakoterapií.

Prolactinomas are the most common hormonally active pituitary adenomas. For women, amenorrhea or other menstrual disturbances are common symptoms of the disease. Diagnosis is based on the detection of hyperprolactinaemia with verification of the adenoma in the region of the Turkish saddle using magnetic resonance imaging. In most cases, cabergoline alone has a good effect. The treatment of macroprolactinomas must be individually considered; a combination of several modalities, such as surgery or gamma-knife irradiation followed by drug therapy, is applied.

• MeSH
• Dopamine Agonists administration & dosage   pharmacology   therapeutic use   MeSH
• Amenorrhea MeSH
• Galactorrhea MeSH
• Hyperprolactinemia diagnosis   etiology   MeSH
• Cabergoline administration & dosage   pharmacology   therapeutic use   MeSH
• Drug Resistance MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Young Adult MeSH
• Pituitary Neoplasms surgery   diagnosis   drug therapy   MeSH
• Treatment Failure MeSH
• Prolactin analysis   blood   drug effects   MeSH
• Prolactinoma * surgery   diagnosis   drug therapy   MeSH
• Radiosurgery MeSH
• Check Tag
• Humans MeSH
• Young Adult MeSH
• Female MeSH

• MeSH
• Hypophysectomy methods   MeSH
• Immunotherapy methods   MeSH
• Ipilimumab therapeutic use   MeSH
• Middle Aged MeSH
• Humans MeSH
• Neoplasm Metastasis MeSH
• Liver Neoplasms surgery   secondary   MeSH
• Nivolumab therapeutic use   MeSH
• Positron Emission Tomography Computed Tomography methods   MeSH
• Prolactin analysis   MeSH
• Prolactinoma * diagnosis   therapy   MeSH
• Antineoplastic Agents therapeutic use   MeSH
• Antineoplastic Combined Chemotherapy Protocols MeSH
• Radiosurgery methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Abnormalities, Drug-Induced etiology   prevention & control   MeSH
• Dopamine Agonists administration & dosage   therapeutic use   MeSH
• Antipsychotic Agents * administration & dosage   therapeutic use   MeSH
• Adult MeSH
• Pregnancy Complications etiology   drug therapy   MeSH
• Lactation drug effects   MeSH
• Delayed-Action Preparations MeSH
• Humans MeSH
• Neonatal Abstinence Syndrome etiology   prevention & control   MeSH
• Schizophrenia, Paranoid * drug therapy   complications   MeSH
• Prolactin physiology   blood   MeSH
• Pregnancy MeSH
• Pregnancy Outcome MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Peripartální kardiomyopatie (PPCM) je vzácná, ale potenciálně život ohrožující forma kardiomyopatie. Projevuje se srdečním selháním u žen bez předchozí kardiální anamnézy v časové návaznosti na období kolem porodu, u kterých nelze tento stav vysvětlit jinou příčinou. Incidence PPCM vykazuje velké geografické rozdíly, patrně kvůli rozdílům v socioekonomických a genetických faktorech. Jde o velmi vzácné onemocnění, v jehož etiologii, patofyziologii i léčbě existuje stále mnoho neznámých. Podle současných představ jsou podkladem patofyziologie peripartální kardiomyopatie genetické predispozice a dále patologické procesy asociované s těhotenstvím - například preeklampsie, nadměrný oxidační stres a hypersekrece prolaktinu. I když je léčba tohoto onemocnění zatím vzdálena kauzálním postupům, PPCM má v podmínkách vyspělých zdravotnických systémů relativně příznivou prognózu.

Peripartum cardiomyopathy is a rare, but potentially life-threatening idiopathic form of cardiomyopathy characterized by manifestation of heart failure within the last month before or 5 months after the labour in previously healthy women when no other cause of heart failure is identified. The incidence of PPCM greatly varies geographically, most likely because of socioeconomic and genetic factors. The etiology, pathophysiology, and treatment of this rare disease are still quite poorly understood. PPCM reflects genetic predisposition and/or can be triggered by pathologic processes associated with pregnancy, such as preeclampsia, oxidative stress, and prolactin hypersecretion. Despite the fact that no causal treatment is yet known, females with PPCM in well developed countries have a relatively good prognosis.

• Keywords
• peripartální kardiomyopatie,
• MeSH
• Cardiomyopathies * diagnosis   physiopathology   therapy   MeSH
• Pregnancy Complications, Cardiovascular MeSH
• Humans MeSH
• Prolactin MeSH
• Pregnancy MeSH
• Check Tag
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

Sexual dysfunctions in men are complex disorders that consist of organic and psychogenic components. The most common sexual dysfunction is erectile dysfunction. It is the inability to achieve or maintain an erection for satisfactory sexual performance. This disorder can be caused by high blood pressure, heart disease, vascular problems, psychological and hormonal factors such as problems with testosterone and prolactin levels. In this study, we tested the relationship between erectile dysfunction, hyperprolactinemia and psychosocial stress. Clinical examinations of 60 patients with erectile dysfunction, which also included psychosocial stress, focussed on patient history, comprehensive sexological examination, biochemical analyses of serum prolactin, total testosterone and thyroid-stimulating hormone with psychometric evaluation of erectile function and a checklist of trauma symptoms (TSC-40). The results show significant Spearman correlations of psychometric evaluation of erectile function with prolactin (R = .50) and results of the trauma checklist score (R = .55) and significant Spearman correlations between TSC-40 and prolactin (R = .52). This result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.

• MeSH
• Penile Erection MeSH
• Erectile Dysfunction * etiology   MeSH
• Hyperprolactinemia * complications   MeSH
• Humans MeSH
• Prolactin MeSH
• Stress, Psychological complications   MeSH
• Testosterone MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH