Baseline testosterone levels as a predictor of hypogonadism resolution in male patients with isolated hyperprolactinemia
Authors' conclusion
In patients with hypogonadism secondary to isolated hyperprolactinemia, gonadal axis recovery occurs frequently, particularly in those with higher baseline TT. Lower PRL levels at diagnosis are associated with a faster recovery of gonadal axis.
Study context
- Population
- Men with central hypogonadism and successfully treated isolated hyperprolactinemia; median age 50 years (IQR 41–58); prolactinoma 79%, non-functioning pituitary adenoma with stalk effect 17%, idiopathic 4%; no TRT within 6 months of prolactin (PRL) normalization
- Participants
- 29 men
- Exposure
- Recovered gonadal axis vs persistent hypogonadism after PRL normalization
- Recoveredn = 20
- Outcome
- Prevalence and timing of gonadal axis restoration after PRL normalization, and factors associated with TT recovery to normal values
Main finding
As reported in the abstract
Spontaneous gonadal axis recovery (normal TT) after successful treatment of hyperprolactinemia
Spontaneously recovered gonadal axis
20 patients
69%
PRL and TT normalized concurrently
10 patients
Median delay of TT normalization after PRL normalization, in the other patients (n=10)
6.5 months
4–9.25
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Baseline TT, recovered vs persistent hypogonadismHigher baseline TT with Recovered | P = 0.02 |
| Baseline PRL at diagnosis, concurrent vs delayed TT normalizationLower baseline PRL with concurrent normalization | P = 0.007 |
Baseline TT as predictor of spontaneous gonadal axis recovery (ROC analysis)
- AUC
- 0.869, p = 0.002
Original publication
Baseline testosterone levels as a predictor of hypogonadism resolution in male patients with isolated hyperprolactinemia. Pituitary. Published 22 June 2025. doi:10.
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