PURPOSE: We reviewed the results of serum @entity251 and prolactin determination in 1,022 @entity1 referred because of @entity323 and compared the data with history, results of physical examination, other etiological investigations and effects of endocrine therapy to refine the rules of cost-effective endocrine screening and to pinpoint actual responsibility for hormonal abnormalities. MATERIALS AND METHODS: @entity251 and prolactin were determined by radioimmunoassay. Every @entity1 was screened for @entity251 and 451 were screened for prolactin on the basis of @entity458 , @entity247 or @entity251 less than 4 ng./ml. Determination was repeated in case of abnormal first results. Prolactin results were compared with those of a previous personal cohort of 1,340 @entity1 with @entity323 and systematic prolactin determination. Main clinical criteria tested regarding efficiency in hormone determination were @entity458 , small testes and @entity247 . Endocrine therapy consisted of @entity2609 or @entity1 chorionic gonadotropin for @entity6126 and @entity2847 for @entity4089 . RESULTS: @entity251 was less than 3 ng./ml. in 107 @entity1 but normal in 40% at repeat determination. The prevalence of repeatedly low @entity251 increased with age (4% before age 50 years and 9% 50 years or older). Two @entity977 were discovered after @entity251 determination. Most of the other low @entity251 levels seemed to result from nonorganic @entity1640 because of normal serum luteinizing hormone and prolactin and to have only a small role in @entity323 (definite improvement in only 16 of 44 [36%] after androgen therapy, normal morning or nocturnal erections in 30% and definite vasculogenic contributions in 42%). Determining @entity251 only in cases of @entity458 or abnormal physical examination would have missed 40% of the cases with low @entity251 , including 37% of those subsequently improved by androgen therapy. Prolactin exceeded 20 ng./ml. in 5 @entity1 and was normal in 2 at repeat determination. Only 1 @entity2013 was discovered. These data are lower than those we found during the last 2 decades (overall prolactin greater than 20 ng./ml. in 1.86% of 1,821 @entity1 , @entity2013 in 7, 0.38%). @entity2847 was definitely effective in cases with prolactin greater than 35 ng./ml. (8 of 12 compared to only 9 of 22 cases with prolactin between 20 and 35 ng./ml.). @entity251 was low in less than 50% of cases with prolactin greater than 35 ng./ml. CONCLUSIONS: Low prevalences and effects of low @entity251 and high prolactin in @entity323 cannot justify their routine determination. However, cost-effective screening strategies recommended so far missed 40 to 50% of cases improved with endocrine therapy and the @entity977 . We now advocate that before age 50 years @entity251 be determined only in cases of @entity458 and abnormal physical examination but that it be measured in all @entity1 older than 50 years. Prolactin should be determined only in cases of @entity458 , @entity247 and/or @entity251 less than 4 ng./ml.

Endocrine screening in 1,022 @entity1 with XXXX : clinical significance and cost-effective strategy.

@entity1 :: ('9606', 'Species') :: ['human', 'patients', 'patient', 'men'] @entity2847 :: ('MESH:D001971', 'Chemical') :: ['bromocriptine', 'Bromocriptine'] @entity251 :: ('MESH:D013739', 'Chemical') :: ['testosterone', 'Testosterone'] @entity323 :: ('MESH:D007172', 'Disease') :: ['erectile dysfunction'] @entity4089 :: ('MESH:D006966', 'Disease') :: ['hyperprolactinemia'] @entity2013 :: ('MESH:D015175', 'Disease') :: ['prolactinoma', 'prolactinomas'] @entity1640 :: ('MESH:D007027', 'Disease') :: ['hypothalamic dysfunction'] @entity458 :: ('MESH:D020018', 'Disease') :: ['low sexual desire'] @entity247 :: ('MESH:D006177', 'Disease') :: ['gynecomastia'] @entity977 :: ('MESH:D010911', 'Disease') :: ['pituitary tumors'] @entity6126 :: ('MESH:D007006', 'Disease') :: ['hypogonadism'] @entity2609 :: ('MESH:C004648', 'Chemical') :: ['testosterone heptylate']
@entity323 :: (MESH:D007172,Disease) :: ['erectile dysfunction']
