title: Case Report: Persistent erectile dysfunction in a man with prolactinoma.
abstract: Erectile dysfunction has been explored as a condition secondary to elevated prolactin; however, the mechanisms by which elevated prolactin levels cause erectile dysfunction have not yet been clearly established. We here present a patient with a history of prolactinoma who suffered from persistent erectile dysfunction despite testosterone supplementation and pharmacological and surgical treatment for the prolactinoma.  Patients who have had both prolactinemia and erectile dysfunction have been reported in the literature, but we find no report of a patient with persistent erectile dysfunction in the setting of testosterone supplementation and persistent hyperprolactinemia refractory to treatment. This case provides evidence supporting the idea that suppression of erectile function occurs in both the central and peripheral nervous systems independent of the hypothalamic-pituitary-gonadal axis.
authors.affiliation: Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Badal
authors.affiliation: Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Ranjith
authors.initials: R
authors.lastname: Ramasamy
authors.affiliation: Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Tariq
authors.initials: T
authors.lastname: Hakky
authors.affiliation: Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Aravind
authors.initials: A
authors.lastname: Chandrashekar
authors.affiliation: Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Lipshultz
keywords: prolactin; sexual dysfunction
references.citation: N Engl J Med. 1978 Oct 19;299(16):847-52
references.pmid: 211411
references.citation: Arch Sex Behav. 2013 Apr;42(3):341
references.pmid: 23297150
references.citation: J Clin Endocrinol Metab. 2004 Feb;89(2):621-5
references.pmid: 14764772
references.citation: BMJ. 2014 Sep 10;349:g5390
references.pmid: 25208537
references.citation: Pituitary. 2015 Jun;18(3):405-9
references.pmid: 25062894
references.citation: Indian J Med Res. 2011 Sep;134:314-9
references.pmid: 21985814
references.citation: Handb Clin Neurol. 2014;124:185-95
references.pmid: 25248588