Effects of prolactin suppression on hypogonadism im patients on maintenance haemodialysis.

The effects of prolactin (Prl) suppression by bromocriptine (BC) on impaired sexual function were studied in 47 male patients on maintenance haemodialysis (HD). All patients had normal serum zinc levels. Before treatment, 14 of 47 patients had moderate hyperprolactinaemia (not due to medication), 24/39 patients had elevated LH levels, 13/34 patients had elevated FSH levels, 26/44 patients had decreased serum testosterone levels and 18/24 patients were oligo-/azöospermic. Bromocriptine was given in doses of 1.25 to 2.5 and 5.0mg/day and each of these doses was maintained for two weeks. Seventeen patients discontinued treatment within the first few days of BC treatment, because of postural hypotension and/or nausea. Fourteen other patients had to be excluded because of poor compliance. On treatment, as little as 1.25mg of BC/day normalised serum Prl, and 2.5mg of BC/day decreased Prl below the lower limit of normal. Neither gonadotrophins nor serum testosterone levels changed significantly during the six weeks of BC treatment.

CONCLUSIONS

1. neither normalisation of moderate hyperprolactinaemia in patients on HD, nor 2. suppression of serum Prl into the subnormal range affects serum gonadotrophin and testosterone levels. 3. These results do not support the hypothesis that moderate hyperprolactinaemia in our patients on HD is an important factor in the development of hypogonadism.