Prolactin is secreted by anterior pituitary cells and its main action is to stimulate the proliferation of mammary epithelial cells, promote the development of the mammary gland during pregnancy and induce lactation. In addition, it acts by binding to its specific receptors in the gonads, lymphocytes and liver. Prolactin is secreted in a pulsatile manner and the person secretes increased amounts during sleep, stress, pregnancy, chest wall irritation or trauma. Normal prolactin levels in men help maintain high levels of testosterone in the testes and influence the growth and secretion of accessory gonads. Hyperprolactinemia is an increase in serum prolactin levels, which interferes with the cyclic release of GnRH, eliminates the pulsatile secretion of gonadotropins, decreases the release of LH and FSH, and ultimately leads to hypogonadism (decreased testosterone synthesis and secretion and hypospermatogenesis). The main symptoms of male related sexual dysfunction are hypoactive sexual desire, penile erectile dysfunction, breast overflow and male breast feminization. When hyperprolactinemia occurs, secondary causes such as stressful conditions after blood sampling, systemic diseases, major life events and medication use should be ruled out first. To ensure the accuracy of the test, fasting blood samples should be tested multiple times. Patients should be questioned in detail about their medications, such as dopamine receptor blockers, dopamine-depleting drugs (methyldopa, reserpine) and some other drugs (tricyclic antidepressants, estrogens, antiandrogen drugs, opioids, H2-blockers, cocaine) that may cause hyperprolactinemia. The most important etiology of primary hyperprolactinemia is a prolactin-secreting pituitary adenoma. A high-resolution CT scan or MRI of the pterygoid area can identify microadenomas (10 mm). Classification of adenomas by radiography alone may lead to errors, as surgery for hyperprolactinemia almost always reveals pituitary adenomas. Prolactinomas are more likely at serum prolactin levels above 250 ng/ml and less likely at serum prolactin levels below 100 ng/ml. When serum prolactin levels are between 100 and 250 ng/ml, it is up to the doctor to decide whether to do an MRI. Prolactinomas are less common in men than in women and are often found incidentally during CT or MRI examinations of the brain, or when tumor compression symptoms, such as visual impairment or headache, are present. The goal of medical treatment for hyperprolactinemia is to relieve symptoms and reduce the size of the tumor. 1/3 of patients with idiopathic hyper-PRL can achieve remission without treatment, or 2/3 if the blood PRL is below 40 ng/ml. asymptomatic patients can be closely monitored without medication. In symptomatic patients, the first recommendation is to discontinue prolactin-increasing drugs and take prolactin-lowering drugs. The dopaminergic nerves of the nodal funnel bundle control the secretion of prolactin. Bromocriptine is a semi-synthetic ergot alkaloid, a potent D2 receptor agonist and partial D1 receptor agonist, which inhibits the secretion of prolactin and has no effect on other pituitary hormones. As the drug of choice for the treatment of hyperprolactinemia, bromocriptine mesylate can reduce prolactin levels in more than 70% of patients. Other drugs are cabergoline and quinagolide, which are more effective and have fewer side effects, but are expensive. They are suitable for those who cannot tolerate bromocriptine. The observation of drug efficacy is mainly based on PRL and other HPG axis hormone measurement and pituitary MRI examination, and the treatment course should last for 12~24 months according to the symptoms and tumor volume changes. Blood PRL is rechecked monthly during the treatment, and later it can be rechecked in 3~6 months, and the drug can be tried to stop after the PRL level is normal. After stopping the drug, 1/6 of patients can maintain normal blood PRL level. Bromocriptine can also reduce the size of tumor, and 90% of those with visual field defects can return to normal. After 1 year of treatment in patients with giant adenoma, 90% of patients can reduce the tumor volume by 50%. Surgery may be considered after 1 to 3 months of treatment without significant results. Bromocriptine can be taken with food or at bedtime to reduce the incidence of gastrointestinal irritation and postural hypotension. When hyperprolactinemia occurs, the effect on sexual function should be observed in conjunction with the patient’s serum LH, FSH and T levels. The effect of treatment is mainly twofold: symptom improvement and restoration of serum HPG hormone homeostasis. The main focus should be on symptom improvement, and the increase or decrease of laboratory indicators should not be overemphasized. In our group of 12 patients, after bromocriptine treatment, serum PRL was significantly reduced, LH and FSH were significantly increased, while T did not change significantly. In addition, the HPG gonadal axis is a feedback system with closely related members (LH, FSH, T), and it is very important and difficult to obtain and maintain its homeostasis, and the relationship between each member is also complicated, with mutual constraints, mutual promotion, and mutual transformation. In the treatment, we should have a global concept, closely observe the patient’s response and laboratory tests, and adjust the program and drugs in time. 1.Bromocriptine has obvious effect and lowers PRL rapidly, blood samples (PRL and T) should be retested after 2 weeks and the efficacy should be observed to adjust the medication in time; 2.Normal level of PRL is necessary to maintain normal sexual function, too low will aggravate ED. 3.Testosterone undecanoate can be used in combination when the effect of bromocriptine alone is unsatisfactory. 4.High recurrence rate of hyperprolactinemia should be closely observed, PRL and T should be tested regularly, and maintenance amount of bromocriptine should be used. 5. Very high PRL values (>100ng/ml) should be considered as pituitary adenoma, and MRI of the pterygoid area should be performed. 6. The recurrence rate of hyperprolactinemia after treatment is as high as 80%, so long course treatment should be emphasized.