Low Testosterone, High Prolactin

Hello,
I will try to make this brief. I have been impotent for 7 years following morphine pump implant surgery for chronic pain after a failed cervical spinal fusion. I lost one testicle after routine hernia surgery 20 years ago. (Doctor's error!)
Knowing that I would be impotent after I was started on the morphine treatment, it was not until about a year ago that I started noticing that all was not quite right. My mood started to change, I started losing body hair, I didn't have to shave every day, things like that. My other testicle and my penis have both started to atrophy as well. I'm getting to the point that something has got to be done quickly. I'm afraid that it has gone on too long now, that If I had seen the changes sooner every thing would be ok. I know about HRT, but what about my testes? Can this atrophy be reversed or at least stopped?
I had blood work done, my Testosterone:98ng/dl total and 16.3pg/ml free, and my Prolactin:29.4ng/ml. The FSH and LH were both within nornal ranges.
I saw a Urologist who wants me to have an MRI of my brain. If he is looking for Prolactinomas of the Pituitary, would they show up on an MRI if it is done without contrast? I know that the Pituitary will not be seen on the MRI without the contrast. But will any tumors be seen without it? He has ordered the MRI of the brain without specifically mentioning the Pituitary gland on his script. Will this be a waste of my time and money?
Thanks for your time in answering my questions.

[Kevin Pho, MD]

Some prolactinomas can be seen without contrast on the MRI.  However, contrast is typically ordered when looking for a pituitary lesion.  I would discuss this before undergoing the test.

Finding the cause of the low testosterone should be sought.  Replacement testosterone therapy can be considered to possibly reverse the atrophy.  I agree with looking for pituitary lesions in light of a normal LH level.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[28Man]

A related discussion, Low level of Testosterone & high Prolactin was started.