Growth hormone, prolactin, and sexuality

Journal of Endocrinological Investigation

Volumn 35, Issue 8, 2012, Pages 782-794

  Galdiero, M ^a   Pivonello, R ^a   Grasso, L F S ^a   Cozzolino, A ^a   Colao, A ^a  

^a UNIVERSITY OF NAPLES FEDERICO II   (Italy)

Author keywords

Acromegaly; GH; GH deficiency; Hyperprolactinemia; Hypoprolactinemia; PRL; Sexual activity; Sexual behavior; Sexual function

Indexed keywords

EID: 84869239336     PISSN: 03914097     EISSN: 17208386     Source Type: Journal    
DOI: 10.1007/BF03345805     Document Type: Review

References (127)

1. Bancroft J. The endocrinology of sexual arousal. J Endocrinol 2005, 186: 411-27. (Pubitemid 41404061)
2. Genazzani AR, Gastaldi M, Bidzinska B, et al. The brain as a target organ of gonadal steroids. Psichoneuroendocrinology 1992, 17: 385-90.
3. Goffin V, Binart N, Touraine P, Kelly PA. Prolactin: the new biology of an old hormone. Annu Rev Physiol 2002, 64: 47-67. (Pubitemid 34259225)
4. Roky R, Paut-Pagano L, Goffin V, et al. Distribution of prolactin receptors in the forebrain: immunohistochemical study. Neuroendocrinology 1996, 63: 422-9.
5. Hair WM, Gubbay O, Jabbour HN, Lincoln GA. Prolactin receptor expression in human testis and accessory tissues: localization and function. Mol Hum Reprod 2002, 8: 606-11. (Pubitemid 34752920)
6. Saito T, Saxena BB. Specific receptors for prolactin in the ovary. Acta Endocrinol (Copenh) 1975, 80: 126-37.
7. Jones RL, Critchley HO, Brooks J, Jabbour HN, McNeilly AS. Localization and temporal expression of prolactin receptor in human endometrium. J Clin Endocrinol Metab 1998, 83: 258-62. (Pubitemid 28498347)
8. Shao R, Nutu M, Weijdegård B, et al. Differences in prolactin receptor (PRLR) in mouse and human fallopian tubes: evidence for multiple regulatory mechanisms controlling PRLR isoform expression in mice. Biol Reprod 2008, 79: 748-57.
9. Rowland DL, Heiman JR, Gladue BA, Hatch JP, Doering CH, Weiler SJ. Endocrine, psychological and genital response to sexual arousal in men. Psychoneuroendocrinology 1987, 12: 149-58. (Pubitemid 17091460)
10. Stoléru SG, Ennaji A, Cournot A, Spira A. LH pulsatile secretion and testosterone blood levels are influenced by sexual arousal in human males. Psychoneuroendocrinology 1993, 18: 205-18. (Pubitemid 23128711)
11. Carani C, Bancroft J, Del Rio G, Granata ARM, Facchinetti F, Marrama P. The endocrine effects of visual erotic stimuli in normal men. Psychoneuroendocrinology 1990, 15: 207-16. (Pubitemid 20313973)
12. Purvis K, Landgren BM, Cekan Z, Diczfalusy E. Endocrine effects of masturbation in men. J Endocrinol 1976, 70: 439-44.
13. Krüger TH, Haake P, Chereath D, et al. Specificity of the neuroendocrine response to orgasm during sexual arousal in men. J Endocrinol 2003, 177: 57-64. (Pubitemid 36592587)
14. Exton NG, Truong TC, Exton MS, et al. Neuroendocrine response to film-induced sexual arousal in men and women. Psychoneuroendocrinology 2000, 25: 189-99.
15. Exton MS, Krüger THC, Koch M, et al. Coitus-induced orgasm stimulated prolactin secretion in healthy subjects. Psychoneuroendocrinology 2001, 26: 287-94. (Pubitemid 32144732)
16. Krüger TH, Hartmann U, Schedlowski M. Prolactinergic and dopaminergic mechanisms underlying sexual arousal and orgasm in humans. World J Urol 2005, 23: 130-8. (Pubitemid 41051504)
17. Drago F, Lissandrello CO. The "low dose" concept and the paradoxical effects of prolactin on grooming and sexual behavior. Eur J Pharmacol 2000, 405: 131-7.
18. Cruz-Casallas PE, Nasello AG, Hucke EE, Felicio LF. Dual modulation of male sexual behavior in rats by central prolactin: relationship with in vivo striatal dopaminergic activity. Psychoneuroendocrinology 1999, 24: 681-93. (Pubitemid 29378497)
19. Nasello AG, Vanzeler ML, Madureira EH, Felicio LF. Effects of acute and long term domperidone treatment on prolactin and gonadal hormone levels and sexual behavior of male and female rats. Pharmacol Biochem Behav 1997, 58: 1089-94. (Pubitemid 28108220)
20. Krüger TH, Haake P, Haverkamp J, et al. Effects of acute prolactin manipulation on sexual drive and function in males. J Endocrinol 2003, 179: 357-65. (Pubitemid 38072087)
21. Corona G, Jannini EA. Lotti F, et al. Premature and delayed ejaculation: two ends of a single continuum influenced by hormonal milieu. Int J Androl 2010, 33: 41-8.
22. Haake P, Exton MS, Haverkamp J, et al. Absence of orgasm induced prolactin secretion in a healthy multi-orgasmic subject. Int J Impot Res 2002, 14: 133-5. (Pubitemid 34450462)
23. Freeman ME, Kanyicska B, Lerant A, Nagy G. Prolactin: structure, function, and regulation of secretion. Physiol Rev 2000, 80: 1523-631.
24. DeMaria JE, Lerant AA, Freeman ME. Prolactin activates all three populations of hypothalamic neuroendocrine dopaminergic neurons in ovariectomized rats. Brain Res1999, 837: 236-41. (Pubitemid 29369237)
25. Björklund A, Moore RY, Nobin A, Stenevi U. The organization of tubero-hypophyseal and reticulo-infundibular catecholamine neuron systems in the rat brain. Brain Res 1973, 51: 171-91.
26. Goudreau JL, Lindley SE, Lookingland KJ, Moore KE. Evidence that hypothalamic periventricular dopamine neurons innervate the intermediate lobe of the rat pituitary. Neuroendocrinology 1992, 56: 100-5.
27. Ganong WF. Circumventricular organs: definition and role in the regulation of endocrine and autonomic function. Clin Exp Pharmacol Physiol 2000, 27: 422-7. (Pubitemid 30313446)
28. Sobrinho LG. The psychogenic effects of prolactin. Acta Endocrinol (Copenh) 1993, 129: 38-40. (Pubitemid 23236061)
29. Hull EM, Lorraine DS, Du J, et al. Hormone-neurotransmitter interactions in the control of sexual behavior. Behav Brain Res 1999, 105: 105-16. (Pubitemid 29447616)
30. Mas M. Neurobiological correlates of masculine sexual behavior. Neurosci Biobehav Rev 1995, 19: 261-77.
31. Pi XJ, Grattan DR. Differential expression of the two forms of prolactin receptor mRNA within microdissected hypothalamic nuclei of the rat. Brain Res Mol Brain Res 1998, 59: 1-12. (Pubitemid 28408441)
32. Lookingland KJ, Moore KE. Effects of estradiol and prolactin on incertohypothalamic dopaminergic neurons in the male rat. Brain Res 1984, 323: 83-91. (Pubitemid 15216772)
33. Bradley K, Meisel RL. Sexual behavior induction of c-Fos in the nucleus accumbens and amphetamine-stimulated locomotor activity are sensitized by previous sexual experience in female Syrian hamsters. J Neurosci 2001, 21: 2123-30. (Pubitemid 32221395)
34. Gonzalez-Mora JL, Guadalupe T, Mas M. In vivo voltammetry study of the modulatory action of prolactin on mesolimbic dopaminergic system. Brain Res Bull 1990, 25: 729-33.
35. Chen JC, Ramirez VD. In vivo dopaminergic activity from the nucleus accumbens, substantia niagra and ventral tegmental area in the freely moving rat: basal neurochemical output and prolactin effect. Neuroendocrinology 1988, 48: 329-35.
36. Robbins TW, Everitt BJ. Functions of dopamine in the dorsal and ventral striatum. Sem Neurosci 1992, 4: 119-28.
37. Chen JC, Ramirez VD. Effects of prolactin on tyrosine hydroxylase activity of central dopaminergic neurons of male rats. Eur J Pharmacol 1989, 166: 473-9. (Pubitemid 19195332)
38. Cebeira M, Hernandez ML, Rodriguez de Fonseca F, de Miguel R, Fernandez-Ruiz JJ, Ramos JA. Lack of effect of prolactin on the dopaminergic receptor sensitivity of striatal and limbic areas after experimentally-induced alterations in peripheral levels. Life Sci 1991, 48: 531-41.
39. Pfaus JG. Pathways of sexual desire. J Sex Med 2009, 6: 1506-33.
40. DeMaria JE, Zelena D, Vecsernyés M, Nagy GM, Freeman ME. The effect of neurointermediate lobe denervation on hypothalamic neuroendocrine dopaminergic neurons. Brain Res 1998, 806: 89-94. (Pubitemid 29009577)
41. Aoki H, Fujioka T, Matsuzaka J, Kubo T, Nakamura K, Yasuda N. Suppression by prolactin of the electrically induced erectile response through its direct effect on the corpus cavernosum penis in the dog. J Urol 1995, 154: 595-600.
42. Ra S, Aoki H, Fujioka T, Sato F, Kubo T, Yasuda N. In vitro contraction of the canine corpus cavernosum penis by direct perfusion with prolactin or growth hormone. J Urol 1996, 156: 522-5. (Pubitemid 126445372)
43. Andersson KE, Wagner G. Physiology of penile erection. Physiol Rev 1995, 75: 191-236.
44. Romano-Torres M, Phillips-Farfán BV, Chavira R, Rodríguez-Manzo G, Fernández-Guasti A. Relationship between sexual satiety and brain androgen receptors. Neuroendocrinology 2007, 85: 16-26. (Pubitemid 46550022)
45. Finley SK, Kritzer MF. Immunoreactivity for intracellular androgen receptors in identified subpopulations of neurons, astrocytes and oligodendrocytes in primate prefrontal cortex. J Neurobiol 1999, 40: 446-57. (Pubitemid 29400052)
46. Carani C, Granata ARM, Faustini Fustini M, Marrama P. Prolactin and testosterone: their role in male sexual function. Int J Androl 1996, 19: 48-54. (Pubitemid 26095335)
47. Meisel RL, Sachs BD. The physiology of male sexual behavior. In: Knobil E, Neill JD (eds). The Physiology of Reproduction. New York: Raven Press. 1994, 3-105.
48. Melis MR, Argiolas A. Dopamine and sexual behavior. Neurosci Biobehav Rev 1995, 19: 19-38.
49. Doherty PC, Wu DE, Matt KS. Hyperprolactinemia preferentially inhibits erectile function in adrenalectomized male rats. Life Sci 1990, 47: 141-8. (Pubitemid 20225970)
50. Doherty PC, Lane SJ, Pfeil KA, Morgan WW, Bartke A, Smith MS. Extra-hypothalamic dopamine is not involved in the effects of hyperprolactinemia on male copulatory behavior. Physiol Behav 1989, 45: 1101-5. (Pubitemid 19205726)
51. Doherty PC, Bartke A, Smith MS, Davis SL. Increased serum prolactin levels mediate the suppressive effects of ectopic pituitary grafts on copulatory behavior in male rats. Horm Behav 1985, 19: 111-21. (Pubitemid 15049668)
52. Bailey DJ, Dolan AL, Pharoah PD, Herbert J. Role of gonadal and adrenal steroids in the impairment of the male rat's sexual behaviour by hyperprolactinaemia. Neuroendocrinology 1984, 39: 555-62. (Pubitemid 15215709)
53. Bartke A, Doherty PC, Steger RW, et al. Effects of estrogen-induced hyperprolactinemia on endocrine and sexual functions in adult male rats. Neuroendocrinology 1984, 39: 126-35. (Pubitemid 14094324)
54. Kalra PS, Simpkins JW, Luttge WG, Kalra SP. Effects on male sex behavior and preoptic dopamine neurons of hyperprolactinemia induced by MtTW15 pituitary tumors. Endocrinol 1983, 113: 2065-71. (Pubitemid 14213570)
55. Dudley CA, Jamison TS, Moss RL. Inhibition of lordosis behavior in the female rat by intraventricular infusion of prolactin and by chronic hyperprolactinemia. Endocrinol 1982, 110: 677-9. (Pubitemid 12162973)
56. Drago F. Prolactin and sexual behavior: a review. Neurosci Biobehav Rev 1984, 8: 433-9. (Pubitemid 15155156)
57. Sato F, Aoki H, Nakamura K, Taguchi M, Aoki T, Yasuda N. Suppressive effects of chronic hyperprolactinemia on penile erection and yawning following administration of apormorphine to pituitary-transplanted rats. J Androl 1997, 18: 21-5. (Pubitemid 27114459)
58. Aoki H, Fujioka T, Matsuzaka J, Kubo T, Nakamura K, Yasuda N. Suppression by prolactin of the electrically induced erectile response through its direct effect on the corpus cavernosum penis in the dog. J Urol 1995, 154: 595-600.
59. Mangurian LP, Walsh RJ, Posner BI. Prolactin enhancement of its own uptake at the choroid plexus. Endocrinology 1992, 131: 698-702.
60. MohanKumar PS, MohanKumar SM, Arbogast L, Quadri SK, Voogt JL. Effects of chronic hyperprolactinemia on tuberoinfundibular dopaminergic neurons. Proc Soc Exp Biol Med 1998, 217: 461-5.
61. Paradisi R, Grossi G, Pintore A, Venturoli S, Porcu E, Capelli M. Evidence for a pathological reduction in brain dopamine metabolism in idiopathic hyperprolactinemia. Acta Endocrinol 1991, 125: 246-52.
62. Hull EM, Bitran D, Pehek EA, Warner RK, Band LC, Holmes GM. Dopaminergic control of male sex behavior in rats: effects of a intracerebrally-infused agonist. Brain Res 1986, 73-81. (Pubitemid 16011050)
63. Buvat J, Lemaire A, Buvat-Herbaut M, Fourlinnie JC, Racadot A, Fossati P. Hyperprolactinemia and sexual function in men. Horm Res 1985, 22: 196-203. (Pubitemid 15239630)
64. Mas M, Fumero B, González-Mora JL. Voltammetric and microdialysismonitoring of brain monoamine neurotransmitter release during psychosexual interactions. Behav Brain Res 1995, 71: 69-79.
65. Bridges RS, Di Biase R, Loundes DD, Doherty PC. Prolactin stimulation of maternal behavior in female rats. Science 1985, 227: 782-4. (Pubitemid 15168273)
66. Delavierre D, Girard P, Peneau M, Ibrahim H. Should plasma prolactin assay be routinely performed in the assessment of erectile dysfunction? Report of a series of 445 patients. Review of the literature. Prog Urol 1999, 9: 1097-101.
67. Buvat J. Hyperprolactinemia and sexual function in men: A short review. Int J Impot Res 2003, 15: 373-7. (Pubitemid 37376944)
68. De Rosa M, Zarrilli S, Vitale G, et al. Six months of treatment with cabergoline restores sexual potency in hyperprolactinemic males: an open longitudinal study monitoring nocturnal penile tumescence. J Clin Endocrinol Metab 2004, 89: 621-5. (Pubitemid 38269868)
69. Buvat J. Hormones and male sexual behavior: physiological and physiopathological data. Contr Fertil Sex 1996, 24: 767-78. (Pubitemid 26364145)
70. Sauder SE, Frager M, Case GD, Kelch RP, Marshall JC. Abnormal patterns of pulsatile luteinizing hormone secretion in women with hyperprolactinemia an amenorrhea: responses to bromocriptine. J Clin Endocrinol Metab 1984, 59: 941-8. (Pubitemid 14020697)
71. Kadioglu P, Yalin AS, Tiryakioglu O, et al. Sexual dysfunction in women with hyperprolactinemia: a pilot study report. J Urol 2005, 174: 1921-5. (Pubitemid 41546983)
72. Koppelman MC, Parry BL, Hamilton JA, Alagna SW, Loriaux DL. Effect of bromocriptine on affect and libido in hyperprolactinemia. Am J Psychiatry 1987, 144: 1037-41. (Pubitemid 17143563)
73. Lobo RA, Kletzky OA. Normalization of androgen and sex hormone-binding globulin levels after treatment of hyperprolactinemia. J Clin Endocr Metab 1982, 56: 562-6. (Pubitemid 13157805)
74. Buvat J. Influence of primary hyperprolactinemia on human sexual behavior. Nouv Presse Med 1982, 11: 3561-3. (Pubitemid 13233899)
75. Walsh JP, Pullan PT. Hyperprolactinaemia in males: a heterogeneous disorder. Aust N Z J Med 1997, 27: 385-90. (Pubitemid 27404842)
76. De Rosa M, Zarrilli S, Di Sarno A, et al. Hyperprolactinemia in men: clinical and biochemical features and response to treatment. Endocrine 2003, 20: 75-82. (Pubitemid 36515190)
77. Colao A, Vitale G, Cappabianca P, et al. Outcome of cabergoline treatment in men with prolactinoma: effects of a 24-month treatment on prolactin levels, tumor mass, recovery of pituitary function, and semen analysis. J Clin Endocrinol Metab 2004, 89: 1704-11. (Pubitemid 38507923)
78. De Rosa M, Ciccarelli A, Zarrilli S et al. The treatment with cabergoline for 24 month normalizes the quality of seminal fluid in hyperprolactinaemic males. Clin Endocrinol (Oxf) 2006, 64: 307-13.
79. Koppelman MC, Parry BL, Hamilton JA, Alagna SW, Loriaux DL. Effect of Bromocriptine on affect and libido in hyperprolactinemia. Am J Psychiatry 1987, 144: 1037-41. (Pubitemid 17143563)
80. De Rosa M, Colao A, Di Sarno A, et al. Cabergoline treatment rapidly improves gonadal function in hyperprolactinemic males: a comparison with bromocriptine. Eur J Endocrinol 1998, 138: 286-93. (Pubitemid 28154778)
81. Soran H, Wu FC. Endocrine causes of erectile dysfunction. Int J Androl 2005, 28: 28-34. (Pubitemid 41719770)
82. Vermeulen A, Ando S, Verdonck L. Prolactinomas, testosterone-binding globulin and androgen metabolism. J Clin Endocr Metab 1982, 54: 409-13.
83. Colao A, Di Sarno A, Cappabianca P, et al. Gender differences in the prevalence, clinical features and response to cabergoline in hyperprolactinemia. Eur J Endocrinol 2003, 148: 325-31. (Pubitemid 36410718)
84. Buvat J, Lemaire A, Buvat-Herbaut M, Marcolin G. Prolactin determination in impotence. Presse Med 1989, 18: 1167.
85. Corona G, Mannucci E, Fisher AD, et al. Effect of hyperprolactinemia in male patients consulting for sexual dysfunction. J Sex Med 2007, 4: 1485-93. (Pubitemid 47337698)
86. Bhasin S, Enzlin P, Coviello A, Basson R. Sexual dysfunction in men and women with endocrine disorders Lancet 2007, 369: 597-611.
87. Corona G, Mannucci E, Jannini EA, et al. Hypoprolactinemia: a new clinical syndrome in patients with sexual dysfunction. J Sex Med 2009, 6: 1457-66.
88. Kopchick JJ, Andry JM. Growth hormone (GH), GH receptor, and signal transduction. Mol Genet Metab 2000, 71: 293-314.
89. Nyberg F. Growth hormone in the brain: characteristics of specific brain targets for the hormone and their functional significance. Front Neuroendocrinol 2000, 21: 330-48.
90. Lobie PE, Breipohl W, Aragón JG, Waters MJ. Cellular localization of the growth hormone receptor/binding protein in the male and female reproductive systems. Endocrinology 1990, 126: 2214-21. (Pubitemid 20139775)
91. Chandrashekar V, Zaczek D, Bartke A. The consequences of altered somatotropic system on reproduction. Biol Reprod 2004, 71: 17-27. (Pubitemid 38915304)
92. Daftary SS, Gore AC. IGF-1 in the brain as a regulator of reproductive neuroendocrine function. Exp Biol Med (Maywood) 2005, 230: 292-306. (Pubitemid 40627681)
93. Hull KL, Harvey S. Growth hormone: a reproductive endocrine-paracrine regulator? Rev Reprod 2000, 5: 175-82.
94. Bellastella A, Esposito D, Conte M, et al. Sexuality in aging male. J Endocrinol Invest 2005, 28 (11 Suppl): 55-60.
95. Becker AJ, Uckert S, Stief CG, et al. Serum levels of human growth hormone during different penile conditions in the cavernous and systemic blood of healthy men and patients with erectile dysfunction. Urology 2002, 59: 609-14. (Pubitemid 34249906)
96. Uckert S, Scheller F, Stief CG, et al. Potential mechanism of action of human growth hormone on isolated human penile erectile tissue. Urology 2010, 75: 968-73.
97. Dahiya R, Chui R, Perinchery G, Nakajima K, Oh BR, Lue TF. Differential gene expression of growth factors in young and old rat penile tissues is associated with erectile dysfunction. Int J Impot Res 1999, 11: 201-6. (Pubitemid 29392825)
98. Hamed EA, Meki AR, Gaafar AA, Hamed SA. Role of some vasoactive mediators in patients with erectile dysfunction: their relationship with angiotensin-converting enzyme and growth hormone. Int J Impot Res 2003, 15: 418-25. (Pubitemid 38101512)
99. Burnett AL, Calvin DC, Silver RI, Peppas DS, Docimo SG. Immunohistochemical description of nitric oxide synthase isoforms in human clitoris. J Urol 1997, 158: 75-8. (Pubitemid 27251597)
100. de Boer H, Blok GJ, Van der Veen EA. Clinical aspects of growth hormone deficiency in adults. Endocr Rev 1995, 16: 63-86.
101. Mc Kenna S, Doward L, Alonso J, et al. The QoL-AGHDA: an instrument for the assessment of quality of life in adults with growth hormone deficiency. Qual. Life Res 1999, 8: 373-83. (Pubitemid 29369642)
102. Rosén T, Wirén L, Wilhelmsen L, Wiklund I, Bengtsson BA. Decreased psychological well-being in adult patients with growth hormone deficiency. Clin Endocrinol (Oxf) 1994, 40: 111-6. (Pubitemid 24193136)
103. Rikken B, van Busschbach J, le Cessie S, et al. Impaired social status of growth hormone deficient adults as compared to controls with short or normal stature. Dutch Growth Hormone Working Group. Clin Endocrinol (Oxf) 1995, 43: 205-11.
104. Thomas JD, Monson JP. Adult GH deficiency throughout lifetime. Eur J Endocrinol 2009, 161: S97-106.
105. Attanasio AF, Shavrikova EP, Blum WF, Shalet SM. Quality of life in childhood onset growth hormone-deficient patients in the transition phase from childhood to adulthood. J Clin Endocrinol Metab 2005, 90: 4525-9. (Pubitemid 41159337)
106. Böger RH, Skamira C, Bode-Böger SM, Brabant G, von zur Muhlen A, Frolich JC. Nitric oxide may mediate the hemodynamic effects of recombinant growth hormone in patients with acquired growth hormone deficiency. J Clin Invest 1996, 98: 2706-13.
107. Tsukahara H, Gordienko DV, Tonshoff B, Gelato MC, Goligorsky MS. Direct demonstration of insulin-like growth factor-1-induced nitric oxide production by endothelial cells. Kidney Int 1994, 45: 598-604. (Pubitemid 24065099)
108. Menezes M, Salvatori R, Oliveira CR, et al. Climacteric in untreated isolated growth hormone deficiency. Menopause 2008, 15: 743-7.
109. Hernberg-Ståhl E, Luger A, Abs R, et al; KIMS International Board; KIMS Study Group. Pharmacia International Metabolic Database. Healthcare consumption decreases in parallell with improvements in quality of life during GH replacement in hypopituitary adults with GH deficiency. J Clin Endocrinol Metab 2001, 86: 5277-81. (Pubitemid 33072095)
110. Colao A, Di Somma C, Cuocolo A, et al. Does a gender-related effect of growth hormone (GH) replacement exist on cardiovascular risk factors, cardiac morphology, and performance and atherosclerosis? Results of a two-year open, prospective study in young adult men and women with severe GH deficiency. J Clin Endocrinol Metab 2005, 90: 5146-55. (Pubitemid 41262267)
111. Gibney J, Wallace J, Spinks T et al. The effects of 10 years of recombinant human growth hormone (GH) in adult GH-deficient patients. J Clin Endocrinol Metab 1999, 84: 2596-602. (Pubitemid 30641978)
112. Carani C, Granata AR, De Rosa M, et al. The effect of chronic treatment with GH on gonadal function in men with isolated GH deficiency. Eur J Endocrinol 1999, 140: 224-30. (Pubitemid 29155580)
113. Rudman D, Feller AG, Nagraj HS, et al. Effects of human growth hormone in men over 60 years old. N Engl J Med 1990, 323: 1-6. (Pubitemid 20209464)
114. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev 2004, 25: 102-52. (Pubitemid 38269977)
115. Jadresic A, Banks LM, Child DF, et al. The acromegaly syndrome. Q J Med 1982, 202: 189-204.
116. Lombardo F, Gandini L, Jannini EA, et al. Diagnosing erectile dysfunction: instruments for endocrine diagnosis. Int J Androl 2005, 28 (Suppl 2): 53-5. (Pubitemid 41719774)
117. Balercia G, Boscaro M, Lombardo F, Carosa E, Lenzi A, Jannini EA. Sexual symptoms in endocrine diseases: psychosomatic perspectives. Psychother Psychosom 2007, 76: 134-40. (Pubitemid 46582016)
118. Bartke A, Meliska C, Milton S, et al. Effects of overexpression of different growth hormone genes on male reproductive functions in transgenic mice. In: Kula K, Slowikowska-Hilczer J, eds. Hormonal Control of Spermatogenesis: Basic and Clinical Aspects. Cracow, Poland: Polish Andrology Society and International Society of Andrology. 1997: 1-15.
119. Webb, SM, Prieto L, Badia X, et al. Acromegaly Quality of Life Questionnaire (ACROQOL) a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties. Clin Endocrinol 2002, 57: 251-8. (Pubitemid 34989102)
120. McVary KT. Erectile dysfunction. N Engl J Med 2007, 357: 2472-81. (Pubitemid 350272786)
121. Brevetti G, Marzullo P, Silvestro A, et al. Early vascular alteration in acromegaly. J Clin Endocrinol Metab 2002, 87: 3175-9.
122. Maison P, Démolis P, Young J, Schaison G, Giudicelli JF, Chanson P. Vascular reactivity in acromegalic patients: preliminary evidence for regional endothelial dysfunction and increased sympathetic vasoconstriction. Clin Endocrinol (Oxf) 2000, 53: 445-51.
123. Galdiero M, Vitale P, Grasso L, et al. Evaluation of male sexual function in active acromegalic patients before and after disease remission: Preliminary study. 2012, Abstract book International/European Congress of Endocrinology. Poster n.1395.
124. Galdiero M, Vitale P, Grasso L, et al. Evaluation of ejaculatory function in acromegalic men: preliminary study. 2012, Abstract book International/ European Congress of Endocrinology, Poster n.1394.
125. Colao A, De Rosa M, Pivonello R, et al. Short-term suppression of GH and IGF-I levels improves gonadal function and sperm parameters in men with acromegaly. J Clin Endocrinol Metab 2002, 87: 4193-7.
126. Melmed S, Ho K, Klibanski A, Reichlin S, Thorner MO. Recent advances in pathogenesis, diagnosis and management of acromegaly. J Clin Endocrinol Metab 1995, 80: 3395-402.
127. Kaltsas GA, Mukherjee JJ, Jenkins PJ, et al. Menstrual irregularity in women with acromegaly. J Clin Endocrinol Metab 1999, 84: 2731-5. (Pubitemid 30642002)