Cabergoline for the Treatment of Male Anorgasmia

Login to Access Video or Poster Abstract: 1495
Date & Time: May 22, 2012 08:00 AM
Session Title: Sexual Function/Dysfunction/Andrology: Medical and Non-Surgical Therapy
Sources of Funding: none

Introduction and Objectives
Anorgasmia is the persistent or frequent absence of orgasm after normal sexual arousal. The risk factors are usually psychological but can also be drug-related or post-prostatectomy sequilae. A prolactin surge has been observed during the post-ejaculatory refractory period, decreasing erectile and ejaculatory potential. We hypothesize that the inhibitory effect of cabergoline on prolactin be a desired endpoint in the treatment of male anorgasmia.

A retrospective review was performed on anorgasmic patients undergoing treatment with cabergoline in a single andrology clinic from 2009 to 2011. All patients were treated with cabergoline 0.5 mg twice a week. Data were analyzed using a linear regression multivariate model.

A total of 107 men treated with cabergoline were identified, and 35 were excluded because of treatment unrelated to anorgamia (e.g. hyperprolactinemia). Data from the 72 remaining anorgasmic patients showed improvement of orgasm in 50 (69%). 26 Of these 50 men (52%) returned to normal orgasm after therapy. Multivariate analysis revealed that the duration of therapy and the concomitant testosterone replacement therapy were associated with significant response to treatment (p=0.02 and 0.03). Mean duration of therapy for non-responders and responders to cabergoline was 214 and 296 days, respectively. No differences in efficacy were found between topical and injectable testosterone replacement. There was not a statistical significant difference of testosterone and prolactin level pre and post treatment. Age or prior prostatectomy did not influence outcome of cabergoline treatment (p=0.9 and 0.42).

This is the first report of cabergoline as an effective treatment option for male anorgasmia. The response is associated with the duration of therapy and concomitant testosterone replacement therapy. Further study is needed to better understand the pathophysiology of male anorgasmia as well as cabergoline’s mechanism of action in these patients.

Hsieh, Tung-Chin (Houston, TX); Hollander, Adam B; Walters, Rustin C; Lipshultz, Larry I 
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