HOT FLUSHES IN MEN WITH PITUITARY-ADENOMA

BACKGROUND Hot flushes are common in menopausal women and also in men made acutely hypogonadal after orchiectomy or testicular injury. It is , however, an unusual symptom in patients with hypogonadism secondary to pituitary tumors. METHODS In evaluating the histories of men with h ypogonadal state associated with nonfunctioning pituitary macroadenoma we were struck by the presence of hot flushes in four of them. RESULT S All four of the patients were hypogonadal with sexual dysfunction pr eoperatively. All had low gonadotropins and low testosterone levels wi th varying degrees of pan-hypopituitarism. All had successful transsph enoidal removal of tumors. None had endocrine improvement following su rgery. All patients had improvement in sexual function and the hot flu shes with administration of testosterone postoperatively. CONCLUSIONS Hot flushes are an uncommon presentation in men with pituitary adenoma . Perhaps the symptom will become more prominent if it is specifically questioned. We postulate that the cause of the flushing is related to nonsuppressed pulsatile secretion of gonadotropin-releasing hormone ( GnRH) from the hypothalamus.