title: Low prolactin is associated with sexual dysfunction and psychological or metabolic disturbances in middle-aged and elderly men: the European Male Aging Study (EMAS).
abstract: BACKGROUND
  We previously reported that in male patients consulting for sexual dysfunction, low prolactin (PRL) levels were associated with metabolic syndrome (MetS), arteriogenic erectile dysfunction, and incident major cardiovascular events.
  
  
  OBJECTIVE
  The aim of this study is to assess the clinical associations of PRL levels in the European Male Ageing Study (EMAS).
  
  
  METHODS
  EMAS is a prospective, observational cohort of community-dwelling men aged 40-79 years old (mean age 60 ± 11 years old). PRL was available for 2,948 men.
  
  
  METHODS
  Different parameters were evaluated including the Short Form-36 questionnaire, Becks Depression Inventory, the Adverse Life Events Scale, the Physical Activity Scale for the Elderly, and the EMAS sexual function questionnaire (EMAS-SFQ).
  
  
  RESULTS
  After the adjustment for confounders, PRL levels were inversely related with worsening of sexual function as compared with the previous year, as derived from change in sexual functioning domain of the EMAS-SFQ (adj. r = -0.043; P = 0.029). The strongest correlation (Wald = 6.840; P = 0.009) was observed between lower PRL levels and reduced enjoyment of orgasmic experiences. Furthermore, an inverse relationship between PRL levels and stressful life events or depressive symptoms was observed. Low PRL was also negatively associated with an unhealthy metabolic phenotype as well as with the MetS (Wald = 5.229; P = 0.022). In line with these data, low PRL was associated with a lower level of physical activity and feeling unhealthier.
  
  
  CONCLUSIONS
  Low PRL is related to several metabolic, psychological, and sexual unhealthy characteristics in European men. Checking PRL might be useful to stratify men for cardiovascular risk and to encourage appropriate lifestyle changes.
authors.affiliation: Sexual Medicine and Andrology Unit Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy; Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corona
authors.forename: Frederick C
authors.initials: FC
authors.lastname: Wu
authors.forename: Giulia
authors.initials: G
authors.lastname: Rastrelli
authors.forename: David M
authors.initials: DM
authors.lastname: Lee
authors.forename: Gianni
authors.initials: G
authors.lastname: Forti
authors.forename: Daryl B
authors.initials: DB
authors.lastname: O'Connor
authors.forename: Terence W
authors.initials: TW
authors.lastname: O'Neill
authors.forename: Neil
authors.initials: N
authors.lastname: Pendleton
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Bartfai
authors.forename: Steven
authors.initials: S
authors.lastname: Boonen
authors.forename: Felipe F
authors.initials: FF
authors.lastname: Casanueva
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Finn
authors.forename: Ilpo T
authors.initials: IT
authors.lastname: Huhtaniemi
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kula
authors.forename: Margus
authors.initials: M
authors.lastname: Punab
authors.forename: Dirk
authors.initials: D
authors.lastname: Vanderschueren
authors.forename: Martin K
authors.initials: MK
authors.lastname: Rutter
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
mesh_terms: D000368:Aged; D000375:Aging / Q000097:blood; D002318:Cardiovascular Diseases; D003863:Depression / Q000097:blood / Q000453:epidemiology*; D007172:Erectile Dysfunction / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D009948:Orgasm; D011388:Prolactin / Q000097:blood / Q000172:deficiency*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D044465:White People
chemical_list: D011388:Prolactin
keywords: Erectile Dysfunction; Metabolic Syndrome; Prolactin