Abstract
While it is well established that chronic stress and long-term glucocorticoid administration inhibit the hypothalamo-pituitary gonadal (HPG) axis, predominantly by interfering with the secretion of gonadotropin releasing hormone (GnRH) as well as of luteinizing hormone (LH) and follicle stimulating hormone (FSH), the effects of acute stress/single high dose glucocorticoid administration on the HPG axis are less well understood. To address this issue we analyzed serum testosterone levels in 30 healthy men divided into two age groups (group 1 aged 20 to 40 and group 2 aged 60 to 80) before and 6h after treatment with a single ultra high dose of dexamethasone (40mg orally). We could show that dexamethasone pretreatment resulted in acute downregulation of testosterone by 29% in the combined age group (mean±SD before dexamethasone 4.7±2.7 [µg/l]; mean±SD after dexamethasone 3.3±1.0 [µg/l]; p<0.05). This effect was more pronounced in the younger age group (42% downregulation compared to 16% in the older age group). In contrast, LH and FSH levels did not change significantly in either age group, indicating a direct testicular effect of dexamethasone. We conclude that high doses of glucocorticoids as produced in situations of physiological or pathological stress can inhibit testosterone production/release directly at the testicular level. This stress response seems to be more pronounced in younger than in older men.
Published Version
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