No difference in prevalence of pituitary imaging abnormalities in men with secondary hypogonadism presenting with decreased bone mineral density versus erectile dysfunction

The aim of this study was to compare the prevalence of pituitary imaging abnormalities in men presenting with decreased bone mineral density (BMD) versus erectile dysfunction and found to have secondary hypogonadism. Medical records of all men referred for erectile dysfunction or decreased BMD and found to have secondary hypogonadism and who had pituitary magnetic resonance imaging (MRI) performed were reviewed. The records of 40 men seen in Endocrine Clinic of the Dallas Veterans Affairs Medical Center were evaluated. Twentyfive men were referred for erectile dysfunction and 15 were referred for decreased BMD. There were no differences between the 2 groups by age, morning pooled testosterone, luteinizing hormone, prolactin, thyroid stimulating hormone, and free thyroxine. Patients with decreased BMD and secondary hypogonadism were found to have lower weight with P value that was statistically significant. MRI abnormalities were found in 16% (4 of 25) of patients with secondary hypogonadism and erectile dysfunction versus 13.3% (2 of 15) of those with decreased BMD and secondary hypogonadism (P = NS). When groups are pooled, patients with pituitary abnormalities on imaging had elevated prolactin (P < 0.006), but no difference in testosterone levels. It can be concluded that in our study population, men who present with decreased BMD or erectile dysfunction and are found to have secondary hypogonadism have similar rate of pituitary abnormalities on MRI.