Disorders of Male Sexual Desire
media.wiley.com/product_data/exc … 767387.pdf
Interesting bit…
Hyperprolactinemia
Increased secretion of prolactin (PRL) may have negative effects on
sexual desire by impairing the pulsatile release of luteinizing hormone
(LH) and subsequently testosterone (Buvat, 2003).
Schwartz, Bauman, and Masters (1982) reported on a series of patients with hyperprolactinemia (HPL) and isolated HSDD and anorgasmia. Patients with HPL commonly have low or low-normal levels of testosterone, but improvement in sexual function by treatment with the
PRL-lowering agent bromocryptine more closely mirrors the lowering of prolactin than the rise in testosterone (T). HPL is also associated with decreased 5-alpha reduction of T to DHT, the more active metabolite, especially on central T receptors.
This effect on sexual desire is consistent with that of 5-alpha reductase inhibitors such as Finasteride (Buvat & Bou Jaoude, 2005).
The effect HPL has on sexual desire may be mediated by the down regulation of central dopamine receptors; hypothalamic dopamine has been consistently implicated in human sexual desire. Not surprisingly, commonly used drugs that interfere with the prolactin-dopamine pathway may affect sexual desire and erectile function (see Table 1.4). Current
recommendations call for the measurement of prolactin levels in
conjunction with testosterone therapy in men with HSDD with or
without associated erectile dysfunction.