Hyperprolactinemia Symptoms in Men

Endocrine Symptoms

Men with hyperprolactinemia often experience decreased libido, erectile dysfunction, and infertility, with a study showing that 4% of men with infertility had elevated prolactin levels 1
The American Urological Association notes that hyperprolactinemia can cause hypogonadism, leading to symptoms such as decreased libido and erectile dysfunction 1
The Endocrine Society recommends that men with hyperprolactinemia be evaluated for hypogonadism, as it is a common symptom of the condition 2

Headaches occur in 13% of patients, especially with large tumors, and are often associated with elevated prolactin levels 2
Visual field defects, such as loss of vision or blurred vision, occur in 13-17% of cases when a large tumor compresses the optic chiasm, and are a common symptom of hyperprolactinemia 2

Gynecomastia is present in 23% of patients, and is often associated with hyperprolactinemia 2
Low testicular volume is often found in men with hyperprolactinemia, with a normal volume being ≥15 ml, and is a common symptom of the condition 1

The European Association of Urology recommends that men with hyperprolactinemia be evaluated for low testosterone levels, as it is a common symptom of the condition 1

The American College of Physicians notes that 15% of cases are discovered incidentally without obvious symptoms, and recommends that prolactin levels be measured in men with decreased libido, erectile dysfunction, or low testosterone levels 1

The Endocrine Society recommends that secondary causes of hyperprolactinemia, such as medications (antipsychotics, antidepressants, antihypertensives), primary hypothyroidism, chronic kidney disease, and severe liver disease, be excluded in men with elevated prolactin levels 2
The European Association of Urology notes that primary hypothyroidism causes hyperprolactinemia in 40% of men, and recommends that thyroid function be evaluated in men with hyperprolactinemia 2

The American College of Radiology recommends that magnetic resonance imaging of the pituitary gland be performed when prolactin levels are markedly elevated (>4000 IU/L or 188 μg/L) or when there are visual symptoms or signs of tumor pressure, regardless of prolactin level 3