ArticleHormones (Athens, Greece)2026
Gonadal recovery in men with prolactinomas on cabergoline: 6-month testosterone levels as a predictor of testosterone replacement timing.
Article in Hormones (Athens, Greece), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeHypogonadotropic hypogonadism is a frequent manifestation of prolactinomas in men. Dopamine agonists can restore gonadal function; however, the timeline and predictors of recovery are not well defined. This study focuses on hypogonadotropic hypogonadism exclusively among men with prolactinomas.
methodsWe retrospectively analyzed 84 men with prolactinomas treated with cabergoline (CAB) for at least 12 months, without prior pituitary surgery or radiotherapy. Hypogonadotropic hypogonadism was defined as morning testosterone < 300 ng/dL with low or inappropriately normal luteinizing hormone (LH). Recovery was defined as testosterone ≥ 300 ng/dL.
resultsAt baseline, 75 patients (89.3%) had hypogonadotropic hypogonadism. Gonadal recovery was observed in 30.7% at 6 months, 44% at 12 months, and 59.5% at 24 months. Mean testosterone increased from 142 ng/dL at baseline to 352.5 ng/dL at 24 months, with continued improvement between 12 and 24 months (p < 0.001). Independent predictors of recovery at 12 months were smaller baseline tumor diameter (OR = 0.934, 95%CI: 0.894-0.977, p = 0.003) and higher baseline testosterone (OR = 1.009, 95%CI: 1.000-1.018, p = 0.042). When 6-month parameters were included, only testosterone at 6 months remained predictive (OR = 1.030, 95%CI: 1.014-1.047, p < 0.001). Optimal cut-offs for persistent hypogonadism at 12 months were tumor diameter > 2.3 cm (sensitivity 64.3%, specificity 63.6%), baseline testosterone < 144.5 ng/dL (sensitivity 63.6%, specificity 61.9%), and 6-month testosterone < 234.0 ng/dL (sensitivity 87.9%, specificity 88.1%).
conclusionGonadal function recovers in a substantial proportion of men with prolactinomas during CAB therapy, often within the first year. Six-month testosterone levels, along with baseline tumor size, are strong predictors of recovery and may help guide testosterone replacement timing.
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