Severe erectile dysfunction is a marker for hyperprolactinemia

The need for routine prolactin (PRL) measurement in the initial evaluation of erectile dysfunction (EDI has been questioned because of the low rate of hyperprolactinemia (HP) in these men and the costs involved, In addition, it is widely thought that sexual desire problems are a good clinical marker for HP and/or low testosterone in men with ED, Within a 15-month period, 8 44 consecutive PRL and sexual hormone determinations were conducted in men at the Kingston General Hospital, Of these patients, 138 were comprehensive ly evaluated at the first visit for ED and completed the International Inde x of Erectile Function (IIEF), In the 138 patients, 2.2% had severe hyperpr olactinemia (> 35 ng/ml), within the range of 1-5% previously reported. No correlation between initial prolactin value and the sexual desire domain or the erectile function domain (EFD) of the IIEF was found for this populati on, However, all cases of severe HP were found to occur in men who scored l ess than 10 in the EFD of the IIEF, Low libido is widely accepted as a mark er of HP, In this study, HP was found in patients not reporting major probl ems with a desire disorder, Clinically significant HP may be reliably found with routine biochemical evaluation and in this series was not detected in patients with EFD scores above 10, A routine PRL measurement is inexpensiv e and early detection of a serious and treatable disease may afford greater therapeutic success.