Prolactinemia in adolescent males surviving malignancies in childhood: impaired dating activity.

A relationship appears to exist between prolactin metabolism and psychosexual development. We studied pubertal stage, testicular size, and serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, thyroxine, thyroid-stimulating hormone (TSH), and prolactin concentrations in 94 adolescent males who had survived malignancies in childhood. Of the patients, 22% had elevated serum prolactin, > 300 mU/L. In multivariate analysis, the only therapeutic agents or treatments found to be independently associated with prolactin concentration were cisplatin and cytosine arabinose. Administration of cisplatin was associated with an increase of 55 m U/L (p < 0.01) and that of cytosine arabinoside with an increase of 23 mU/L (p < 0.01) in serum prolactin concentration. Serum prolactin concentration correlated with serum FSH (r = 0.26, p = 0.16) and LH (r = 0.30, p = 0.005). In 45 of the patients 10 criteria of psychosexual development were evaluated using a personal, semi-structured, and psychodynamically-oriented interview. A significant inverse relation existed between serum prolactin concentration and dating with the opposite sex (p = 0.008); none of the patients with elevated serum prolactin were dating. We conclude that even a slight elevation of serum prolactin above normal is associated with or may be reflected in the psychosexual development of adolescent males who have survived malignancies in childhood.