Department of Urology and Reproductive Medicine, Male Infertility Genetics Laboratory, Weill Cornell Medical College, New York, NY, USA.
Curr Opin Urol. 2011 Nov;21(6):527-34. doi: 10.1097/MOU.0b013e32834bdf01.
To review physiology of prolactin (PRL), cause and managment of hyperprolactinemia, and discuss evolving diverse roles of PRL in men's health.
Hyperprolactinemia can be physiologically found after sexual activities, exercise, lactation, during pregnancy, and after stressful venipuncture. Elevated PRL can be caused by medications use, renal failure, hypothyroidism, and by prolactinoma - PRL secreting tumors. Symptomatic hyperprolactinemia and prolactinomas should be treated to lower PRL levels, decrease tumor size, and restore gonadal function. Three modes of treatment are typically utilized: pharmacological, radiosurgery with gamma radiation, and external beam radiation. Pharmacological treatment of prolactinomas is mainly based on dopamine agonists. The most frequently used dopamine agonists are bromocriptine and cabergoline. Cabergoline becoming the preferred drug in the treatment of prolactinomas because of higher response rate and less side-effects. Bromocriptine has been recently approved to improve glycemic control in diabetes mellitus.
PRL plays a diverse role in men's reproduction and health. Detecting and treating elevated PRL may not only improve infertility and hypogonadism but also have a positive effect on the metabolic profile of patient and control of glycemic control and metabolic profile - an important advantage considering dramatic and worldwide increase in obesity and diabetes.
回顾催乳素（PRL）的生理学、高催乳素血症的病因和治疗，并讨论 PRL 在男性健康中的多种作用。
性行为、运动、哺乳、妊娠和应激性静脉穿刺后，催乳素会生理性升高。药物使用、肾衰竭、甲状腺功能减退和催乳素瘤（分泌催乳素的肿瘤）可引起催乳素升高。应治疗有症状的高催乳素血症和催乳素瘤，以降低催乳素水平、缩小肿瘤体积和恢复性腺功能。通常采用三种治疗模式：药物治疗、伽玛刀放射外科治疗和外照射治疗。催乳素瘤的药物治疗主要基于多巴胺激动剂。最常用的多巴胺激动剂是溴隐亭和卡麦角林。卡麦角林因更高的反应率和更少的副作用而成为治疗催乳素瘤的首选药物。溴隐亭最近被批准用于改善糖尿病患者的血糖控制。
PRL 在男性生殖和健康中发挥着多种作用。检测和治疗升高的 PRL 不仅可以改善不育和性腺功能减退，还可以对患者的代谢状况产生积极影响，并控制血糖控制和代谢状况——考虑到肥胖和糖尿病在全球范围内的急剧增加，这是一个重要的优势。
