Prevalence of Prolactinoma in Men with Hypogonadism

Clinical Implications for Evaluation

When evaluating men with hypogonadism, prolactin measurement should be performed to screen for prolactinoma, particularly in those presenting with sexual dysfunction, visual field defects, or headaches, as recommended by the Endocrine Society 1
Prolactin levels in men with prolactinomas typically exceed 4,000 mU/L, with median levels around 20,000 mU/L, according to the Endocrine Society 3
Serial dilutions should be performed in men with large pituitary lesions but paradoxically normal or mildly elevated prolactin to detect the "high-dose hook effect", as suggested by the Endocrine Society 4

The American Association of Clinical Endocrinologists recommends that men with hypogonadism and suspected prolactinoma should undergo serial dilutions to detect the "high-dose hook effect" 4