THE USE OF TESTOSTERONE PROPIONATE IN FUNCTIONAL BLEEDING

Abstract

The present communication is a report on the use of testosterone propionate (male sex hormone) in functional uterine bleeding. Of 25 cases so treated, the excessive bleeding was rapidly controlled in all but two. This clinical improvement was correlated with definite changes in the endometrium, as revealed by suction biopsies performed at intervals before, during and after treatment. The rationale for this form of therapy has its basis in animal experimentation as well as in our studies on the effect of testosterone propionate on the endometrial cycle of the human. Suppression of the estrus cycle in female rats was first induced with male hormone extracts of bull testes by Ihrke and D'Amour (1). Similar results were obtained with testosterone by Robson (2) in mice and Browman (3) in rats. In monkeys, Hartman (4) has shown that menstruation was delayed following testosterone administration, and Zuckerman (5) has reported that testosterone propionate inhibits follicle stimulation and luteinization, resulting in suppression of the menses. Cotte, Martin and Mankiewicz (6) reported similar results in rabbits. In a previous report (7) we have shown that administration of adequate doses of testosterone propionate causes striking morphologic changes in the endometrium of regularly menstruating women, associated with suppression of the succeeding menstrual period. These changes consist of the disappearance of the secretory phase and inhibition of the proliferative phenomena. The inhibition of proliferative activity in the endometrium, together with the suppression of the menses, suggested the use of male hormone in functional uterine bleeding. The hormone selected for this investigation was synthetic testosterone propionateinasmuch as it has been shown to be the most potent preparation available (8, 9).