Department of Molecular and Clinical Endocrinology and Oncology, Section of Endocrinology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy.
J Endocrinol Invest. 2012 Sep;35(8):782-94. doi: 10.1007/BF03345805.
GH and PRL, although not considered as 'classical' sexual hormones, could play a role in the endocrine control of sexual function both in men and women. Physiologically, PRL seems to be involved in the central control of sexual behavior and activity, by modulating mainly the effects of dopaminergic and serotoninergic systems on sexual function. Indeed, circulating PRL levels increase after orgasm and may potentially play a role in the acute regulation of further sexual arousal following orgasm both in men and women. On the other hand, either short-term or long-term PRL increase can modulate central nervous system areas involved in the control of sexual function and, peripherally, can directly influence mechanisms of penile erection in men, and presently only as an hypothesis, mechanisms related to the sexual response of genitalia in women. Furthermore, chronic hyperprolactinemia is classically associated with hypogonadotropic hypogonadism and sexual dysfunction in both sexes. Successful treatment of chronic hyperprolactinemia generally restores normal sexual function both in men and women although this effect is not only related to relapse of gonadal function. Hypoprolactinemia is recently recognised as a possible risk factor of arteriogenic erectile dysfunction while a possible role on female sexual function is not known. The physiological role of GH on sexual function is not fully elucidated. GH is an important regulator of hypothalamuspituitary- gonadal axis and seems to participate in the regulation of the sexual response of genitalia in men, and potentially also in women. Sexual function in men and women with GH deficiency (GHD) and GH excess, particularly in acromegaly, is scantily studied and GH- or IGF-I-dependent effects are difficult to quantify. Nevertheless, a decrease of desire and arousability both in men and women, together with an impairment of erectile function in men, have been described both in patients with GHD and acromegaly, although it is not clear whether they are dependent directly on the hormone defect or excess or they are consequence of the hypogonadism or the different clinical complications or the physical disfigurement and psychological imbalance, which are associated with the diseases, and are potentially affecting sexual function. Data on beneficial effects of GH replacement therapy and specific surgical or pharmacological approach for acromegaly are far to be fully elucidated although restoring normal GH/IGF-I levels have been associated to improvement of sexual function.
虽然 GH 和 PRL 不被视为“经典”性激素，但它们在男性和女性的性功能内分泌控制中可能发挥作用。从生理学上讲，PRL 似乎参与了性行为和活动的中枢控制，主要通过调节多巴胺能和 5-羟色胺能系统对性功能的影响来发挥作用。事实上，PRL 的循环水平在射精后会升高，并且可能在男性和女性射精后进一步性唤起的急性调节中发挥作用。另一方面，无论是短期还是长期的 PRL 增加都可以调节参与性功能控制的中枢神经系统区域，并且在男性中可以直接影响阴茎勃起的机制，目前只是一个假设，而在女性中与生殖器性反应相关的机制。此外，慢性高催乳素血症通常与两性的促性腺激素分泌不足性性腺功能减退和性功能障碍相关。慢性高催乳素血症的成功治疗通常可恢复男性和女性的正常性功能，尽管这种效果不仅与性腺功能的恢复有关。目前认为低催乳素血症是动脉性勃起功能障碍的一个可能危险因素，而其对女性性功能的作用尚不清楚。GH 对性功能的生理作用尚未完全阐明。GH 是下丘脑-垂体-性腺轴的重要调节剂，似乎参与了男性生殖器性反应的调节，并且可能也参与了女性的调节。GH 缺乏（GHD）和 GH 过多（尤其是肢端肥大症）的男性和女性的性功能研究甚少，并且难以量化 GH 或 IGF-I 依赖性作用。然而，无论是男性还是女性，欲望和唤起能力都会下降，男性的勃起功能也会受损，在 GHD 和肢端肥大症患者中都有描述，尽管尚不清楚它们是直接依赖于激素缺陷或过多，还是由于性腺功能减退或不同的临床并发症或身体畸形和心理失衡所致，这些都与疾病相关，并可能对性功能产生影响。尽管恢复正常的 GH/IGF-I 水平与性功能的改善相关，但 GH 替代治疗和特定的肢端肥大症手术或药物治疗的有益效果的数据远未完全阐明。
