Sexual dysfunction in patients with hypothalamo-pituitary disorders.

Four different studies of sexual problems and sexual dysfunction in patients with hypothalamo-pituitary disorders have been undertaken and data about the sex life of the patients have been correlated with diagnosis, tumour extension and pathology, endocrine insufficiency and pituitary hormone hypersecretion. In the first study 48 out of 53 (76.2%) adult males with pituitary tumours reported decreased or absent sexual desire. The corresponding figure in the second study was 29 out of 37 (78.4%) among adult males with pituitary tumours and hyperprolactinaemia. Twenty (31.7%) and 18 (48.6%) patients, respectively, reported decreased sexual desire as the first symptom of their tumour. A highly significant correlation between a decrease in serum testosterone and a decrease in sexual desire was found. Some males with normal serum testosterone but hyperprolactinaemia also reported decreased sexual desire. In the third study, 109 females (aged 20-60) with morphologically verified hypothalamo-pituitary disorders, 68 (62.4%) had noticed a decrease in sexual desire. This problem was registered for 53 (84.1%) out of the 63 women in this group who had hyperprolactinaemia but only in 15 (32.6%) out of the 46 women with normal serum prolactin (p less than 0.001). In the last study 48 women with well-defined hypothalamo-pituitary disorders underwent a comprehensive interview about sexual function and sexual appreciation. Thirty-eight (79.2%) of the women had developed a lack of or a considerable decrease in sexual desire. Problems with lubrication or orgasms were reported by 31 (64.6%) and 33 (68.7%) of the women, respectively. Preservation of normal menstrual pattern, age, and intrasellar tumour growth was correlated to normal sexual desire and function.(ABSTRACT TRUNCATED AT 250 WORDS)