Winters S J, Troen P
Clin Endocrinol (Oxf). 1984 Sep;21(3):257-63. doi: 10.1111/j.1365-2265.1984.tb03467.x.
To explore the mechanism for the hypogonadism associated with prolactin hypersecretion in men we examined luteinizing hormone (LH) secretory profiles in four hyperprolactinaemic men before and during treatment with bromocriptine. Pretreatment serum prolactin levels were increased 4-100 fold and serum testosterone levels were low in three men and low-normal in the fourth subject. Mean LH levels were low-normal and the frequency of spontaneous LH secretory episodes was less than normal in three of four men. Bromocriptine reduced serum prolactin levels to normal; subsequently, serum testosterone levels increased and libido and potency improved markedly in each man. The rise in serum testosterone levels was associated with an increase in mean LH concentrations and in LH pulse frequency. Mean follicle-stimulating hormone levels also increased during bromocriptine treatment. Insofar as each LH pulse is believed to reflect a discharge of gonadotrophin releasing hormone from the anterior hypothalamus, our data suggest that a major abnormality in hyperprolactinaemic men with hypogonadism is a disorder of the neuroregulatory mechanism for pulsatile gonadotrophin-releasing hormone secretion.
为探讨男性高泌乳素血症伴性腺功能减退的机制，我们检测了4例高泌乳素血症男性在服用溴隐亭治疗前及治疗期间的黄体生成素（LH）分泌情况。治疗前，3例患者血清泌乳素水平升高4至100倍，血清睾酮水平降低，第4例患者血清睾酮水平处于低正常范围。4例患者中有3例的平均LH水平处于低正常范围，自发性LH分泌脉冲频率低于正常。溴隐亭使血清泌乳素水平降至正常；随后，每位患者的血清睾酮水平升高，性欲和性功能明显改善。血清睾酮水平的升高与平均LH浓度及LH脉冲频率的增加相关。溴隐亭治疗期间，平均促卵泡生成素水平也升高。鉴于认为每个LH脉冲反映了下丘脑前部促性腺激素释放激素的释放，我们的数据表明，高泌乳素血症伴性腺功能减退男性的一个主要异常是脉冲性促性腺激素释放激素分泌的神经调节机制紊乱。
