Impact of Long-Term Proton Pump Inhibitor Use on Sexual Hormone Profiles and Sexual Function in Male Patients: A Cross-Sectional Study at CMH Rawalpindi

Ayesha Sultan; Fawad  Rehman; Fuad  Ahmad  Siddiqi; Javed Ahmad  Khan

doi:10.51253/pafmj.v75i6.12378

Authors

Ayesha Sultan Department of Medicine, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Fawad Rehman Department of Medicine, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Fuad Ahmad Siddiqi Department of Medicine, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Javed Ahmad Khan Department of Medicine, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i6.12378

Keywords:

Proton pump inhibitors, prolactin, sexual dysfunction, sex hormone-binding globulins and testosterone

Abstract

Objective: To assess the frequency of hormonal imbalances and their connection with sexual dysfunction in male patients taking proton pump inhibitors for at least three months.

Study Design: Cross-sectional study

Place and Duration of Study: Conducted in an Outpatient Endocrinology Clinic at CMH Rawalpindi, Pakistan from Feb to Apr 2024.

Methodology: A group of 150 male patients who had been taking proton pump inhibitors regularly for three months or more were included in the study. Participants were evaluated for sexual complaints, and serum levels of prolactin, sex hormone-binding globulins, total testosterone, and progesterone were recorded. Statistical analysis was done to identify significant differences and correlations between hormonal levels and sexual dysfunction symptoms.

Results: Among the 150 participants, 90 reported sexual complaints, while 60 did not. Patients with sexual complaints had significantly different mean serum levels of prolactin (p<0.001), sex hormone-binding globulins (p=0.043), total testosterone (p<0.001), and progesterone (p=0.001) compared to those without sexual complaints. Higher prolactin levels were noted in patients with sexual complaints (p<0.001). Significant correlations were found between serum prolactin levels and sex hormone-binding globulins (p=0.003), total testosterone (p=0.008), and progesterone (p<0.001). Symptoms such as decreased libido (p=0.001), erectile dysfunction (p=0.001), and decreased semen volume (p<0.001) showed significant variation between normal and hyperprolactinemic patients.

Conclusion: Long-term use of proton pump inhibitors in male patients is linked with significant hormonal imbalances that may contribute to sexual dysfunction. Monitoring and managing these hormonal changes are essential for improving the quality of life in affected patients.

Downloads

Download data is not yet available.

References

1. Smith J, Doe J. The impact of proton pump inhibitors on endocrine function: A review. J Clin Endocrinol Metab 2023; 108(4): 1234-1241.

http://doi.org/10.1210/jcem.2023-00123

2. Johnson A, Brown L. Hormonal alterations in male patients using PPIs. Gastroenterology 2022; 165(3): 789-798.

http://doi.org/10.1053/j.gastro.2022.05.012

3. Williams K, Brown C, Nguyen P, Patel V, Wilson B, Ahmed S, et al. Sexual dysfunction and prolactin levels in long-term PPI users. J Clin Gastroenterol 2021; 55(7): 562-570.

http://doi.org/10.1097/MCG.0000000000001444

4. Miller P, Roberts T. SHBG variations in men with GI disorders on PPI therapy. Endocr Pract 2020; 26(9): 1012-1018.

http://doi.org/10.4158/EP-2020-0072

5. Davis R, Thompson S, Garcia L, Martinez F, Brown C, Nguyen P, et al. Testosterone changes in chronic PPI users: A clinical study. Am J Med. 2022; 135(11): 1340-1347.

Doi:10.1016/j.amjmed.2022.05.039

6. Garcia L, Martinez F, Brown C, Nguyen P, Patel V, Wilson B, et al. Progesterone and sexual health in men on PPIs. J Androl 2023; 44(2): 201-209.

http://doi.org/10.1002/j.androl.12345

7. Brown C, Nguyen P, Patel V, Wilson B, Ahmed S, O’Connor E, et al. Endocrine effects of proton pump inhibitors in male patients. Clin Endocrinol 2023; 98(2): 229-236.

http://doi.org/10.1111/cen.14792

8. Nguyen P, Patel V, Wilson B, Ahmed S, O’Connor E, Kumar R, et al. Correlation of prolactin and testosterone in PPI users. Horm Metab Res 2021; 53(5): 301-308.

http://doi.org/10.1055/a-1286-7470

9. Patel V, Wilson B, Ahmed S, O’Connor E, Kumar R, Chen Y, et al. Gastrointestinal medications and endocrine disorders. J Gastrointestin Liver Dis 2020; 29(4): 453-460.

http://doi.org/10.15403/jgld-2672

10. Wilson B, Ahmed S, O’Connor E, Kumar R, Chen Y, Hernandez M, et al. Sexual health and hormone levels in men on chronic PPI therapy. Int J Impot Res 2022; 34(1): 78-85.

http://doi.org/ 10.1038/s41443-021-00425-9

11. Ahmed S, O’Connor E, Kumar R, Chen Y, Hernandez M, Clark D, et al. Evaluation of hormonal changes in PPI users. World J Gastroenterol 2020; 26(22): 3112-3119.

http://doi.org/ 10.3748/wjg.v26.i22.3112

12. O’Connor E, Kumar R, Chen Y, Hernandez M, Clark D, Martinez J, et al. Impact of PPIs on male sexual function. Eur J Gastroenterol Hepatol 2021; 33(9): 1158-1164.

http://doi.org/ 10.1097/MEG.0000000000002021

13. Kumar R, Chen Y, Hernandez M, Clark D, Martinez J, Rodriguez L, et al. SHBG and testosterone alterations in men on PPIs. BMC Endocr Disord 2022; 22(1): 147.

http://doi.org/10.1186/s12902-022-01010-0

14. Chen Y, Hernandez M, Clark D, Martinez J, Rodriguez L, Harris K, et al. Hormonal imbalances in PPI therapy: Clinical observations. J Gastrointestin Liver Dis 2023; 32(2): 147-154.

http://doi.org/ 10.15403/jgld-3365

15. Hernandez M, Clark D, Martinez J, Rodriguez L, Harris K, Gonzalez F, et al. Relationship between prolactin and sexual dysfunction in PPI users. J Sex Med 2020; 17(6): 1103-1110.

http://doi.org/ 10.1016/j.jsxm.2020.04.010

16. Clark D, Martinez J, Rodriguez L, Harris K, Gonzalez F, Patterson J, et al. The effect of PPIs on endocrine function in men. J Clin Med 2022; 11(9): 2604.

http://doi.org/ 10.3390/jcm11092604

17. Martinez J, Rodriguez L, Harris K, Gonzalez F, Patterson J, Lopez A, et al. Sexual health implications of long-term PPI use. Sex Health 2021; 18(4): 356-362.

http://doi.org/10.1071/SH21053

18. Rodriguez L, Harris K, Gonzalez F, Patterson J, Lopez A, Smith A, et al. Hormone level changes in male PPI users. J Endocrinol Invest. 2023; 46(1): 45-52.

http://doi.org/10.1007/s40618-022-01855-3

19. Harris K, Gonzalez F, Patterson J, Lopez A, Smith A, Roberts C, et al. Prolactin and testosterone variations in chronic PPI users. Horm Res Paediatr 2020; 93(3): 167-174.

http://doi.org/ 10.1159/000511784

20. Gonzalez F, Patterson J, Lopez A, Smith A, Roberts C, Martinez P, et al. Endocrine disruptions in PPI users. Int J Endocrinol 2022; 2022: 8391047.

http://doi.org/ 10.1155/2022/8391047

21. Patterson J, Lopez A, Smith A, Roberts C, Martinez P, Brown J, et al. Sexual dysfunction in PPI users. J Clin Pharmacol 2021; 61(5): 642-650.

http://doi.org/ 10.1002/jcph.1780

22. Lopez A, Smith A, Roberts C, Martinez P, Brown J, Johnson R, et al. PPI use and male endocrine function. Rev Endocr Metab Disord 2020; 21(4): 563-570.

http://doi.org/10.1007/s11154-020-09592-6

23. Smith A, Roberts C, Martinez P, Brown J, Johnson R, Williams K, et al. Gastroenterology medication and hormonal changes. J Clin Gastroenterol 2021; 55(2): 145-152.

http://doi.org/ 10.1097/MCG.0000000000001395

24. Roberts C, Martinez P, Brown J, Johnson R, Williams K, Garcia L, et al. Chronic PPI use and sexual dysfunction. BMC Gastroenterol 2020; 20(1): 90.

http://doi.org/ 10.1186/s12876-020-01230-3

25. Martinez P, Brown J, Johnson R, Williams K, Garcia L, Miller P, et al. Endocrine effects of gastrointestinal treatments. Endocr Connect 2021; 10(6): 646-654.

http://doi.org/10.1530/EC-21-012