Treatment Of Hypogonadism Research Articles

Transdermal testosterone therapy in the treatment of male hypogonadism.

Five hypogonadal men were treated with transdermal testosterone therapy, using a testosterone patch applied to the scrotal skin. Daily application of the patch, which contained 10 mg testosterone, produced an increase in serum testosterone concentrations from a pretreatment value of 45 +/- 12 (+/- SE; 1.5 +/- 0.4) to 436 +/- 80 ng/dL (15.1 +/- 2.8 nmol/L; P less than 0.001) after 4 weeks of treatment. Normal serum testosterone concentrations were achieved in all men after 6-8 weeks of therapy and were maintained during continued long term therapy for 9-12 months with a patch containing 15 mg testosterone. All men reported a subjective increase in libido and sexual function during therapy, and three men preferred it to testosterone injections. The serum testosterone and estradiol levels did not rise above the normal adult male range at any time during therapy. However, elevated serum dihydrotestosterone (DHT) concentrations occurred during treatment; the pretreatment DHT concentration was 95 +/- 3 ng/dL (3.3 +/- 0.1 nmol/L), and it increased to 228 +/- 40 ng/dL (7.8 +/- 1.4 nmol/L) after 4 weeks of treatment and remained elevated thereafter. The individual mean DHT to testosterone ratio increased from a pretreatment value of 0.2 (range, 0.1-0.3) to 0.6 (range, 0.4-0.7) after 2 weeks of therapy and remained high thereafter. Comparison of the serum DHT levels in patients during therapy with those in normal men who had similar testosterone concentrations [531 +/- 62 vs. 566 +/- 72 ng/dL (18.4 +/- 2.1 vs. 19.6 +/- 2.5 nmol/L); P greater than 0.05] revealed that the mean serum DHT concentration was significantly higher in the patients [315 +/- 69 vs. 87 +/- 6 ng/dL (10.8 +/- 2.4 vs. 2.9 +/- 0.2 nmol/L); P less than 0.001], as was the mean DHT to testosterone ratio [0.6 (range, 0.25- 1.1) vs. 0.16 (range, 0.09- 0.24); P less than 0.001]. The high serum DHT levels presumably were due to increased metabolism of testosterone to DHT by the 5 alpha-reductase in the scrotal skin. Serum 3 alpha-androstanediol glucuronide levels were not elevated in the patients. We conclude that transdermal testosterone therapy is an effective long term treatment for hypogonadism in men. It is, however, associated with high serum DHT levels, whose potential long term effects on the prostate and other tissues need to be investigated.

The role of gonadotrophin releasing hormone in the investigation and treatment of hypogonadism.

Journal Article The role of gonadotrophin releasing hormone in the investigation and treatment of hypogonadism Get access A Gossage, A Gossage Department of Medicine, Clinical Sciences Centre, Northern General Hospital, Herries Road, Sheffield S5 7AU UK Search for other works by this author on: Oxford Academic Google Scholar S Duncan S Duncan Department of Obstetrics/Gynaecology, Clinical Sciences Centre, Northern General Hospital, Herries Road, Sheffield S5 7AU UK Search for other works by this author on: Oxford Academic Google Scholar Postgraduate Medical Journal, Volume 61, Issue 713, March 1985, Pages 195–200, https://doi.org/10.1136/pgmj.61.713.195 Published: 01 March 1985 Article history Accepted: 25 July 1984 Published: 01 March 1985

Characterization of a human anti-hCG antiserum: A proposed standard for laboratories involved with the development of hCG vaccines

An antiserum (PC-81-1) was obtained fron a man who developed antibodies against hCG during treatment for hypogonadism. The antiserum was unique in that its affinity for hCG was high (> 10 10M −1) and its cross-reaction with hLH and the hCG-subunits was only 1–12.5% and 0.01%, respectively, of intact hCG. We propose that this human antiserum be used as a laboratory standard by investigators who are developing vaccines directed against hCG. The use of this standard in the proposed protocol will permit comparison of titers between laboratories. Lyophilized samples of antiserum PC-81-1 are available on request from the Population Council.

Bromocriptine in the Treatment of Hypogonadism and Male Impotence

A rapid, practical diagnostic scheme is the key to selecting proper candidates for treatment with bromocriptine. The evaluation centres around assays for prolactin and follicle stimulating hormone, polytomography and computerised axial tomography of the sella turcica and parasellar regions, and the ergot alkaloid, bromocriptine. Additionally, bromocriptine is of significant value in the treatment of men and women with hypogonadotrophic hypogonadism. Approximately 80% of patients with hypogonadotrophic hypogadism and hyperprolactinaemia will respond favorably to bromocriptine therapy. In women who conceive during such treatment there appears to be no increase in the rate of spontaneous abortion, of multiple gestations or of congenital anomalies. Bromocriptine appears to be of little value in the treatment of male impotence unless hyperprolactinaemia is a component of the disease. Side affects are usually mild and transient. Following the discontinuation of therapy most patients have a recurrence of hyperprolactinaemia and hypogonadism.

Do androgens increase Leydig cell sensitivity to luteinising hormone?

TARGET tissue responsiveness to hormones is not a static phenomenon, but is often influenced by the endocrine situation. For example, the sensitivity of the Leydig cell in the rat to luteinising hormone (LH) stimulation is not constant but gradually increases during prepubertal development1. Moreover, during treatment of hypogonadism in the human male, human chorionic gonadotrophin (hCG) therapy is often increasingly efficacious in stimulating testosterone secretion after repeated injections—a probable manifestation of induced target cell sensitivity. It is possible that androgen receptors in the Leydig cell2,3 are involved in the regulation of these changes in sensitivity. They are specific for testosterone and dihydrotestosterone4,5 and are distinct from the oestrogen receptors in the same cell3,6. We have investigated a possible role for these androgen receptors using the testicular feminised male (Tfm) rat. This rat has a male genotype and abdominal or inguinal testes, but a typical female phenotype because of a genetically determined lack of androgen receptors and a generalised target organ insensitivity to androgen7. We report here that the Leydig cells of the Tfm rat testis have much smaller number of LH/hCG receptors than normal, and this is associated with a low sensitivity to hCG.

THERAPY WITH AQUEOUS SUSPENSIONS OF TESTOSTERONE

TREATMENT of hypogonadism in males has been carried out with testosterone propionate and with methyl testosterone. The pure steroid, testosterone, has been used also in pellet form by implantation. Recently aqueous suspensions of estrogenic steroids have been employed in treating women in the climacteric. A trial of a similar suspension of pure testosterone was undertaken. The preparation used contained 20 mg. testosterone in 1 cc., and was furnished in sealed glass ampoules.2 Prior to removal into the syringe for intramuscular injection the content of the ampoule was agitated vigorously by hand to assure a uniform suspension. No pain was experienced by the patients, and no local reactions were observed. Patients learned with ease to make their own injections. The results are illustrated herein by reports of a series of five men who were treated for hypogonadism due either to a delayed development or to the climacteric. Case 1, D.F., Wis. Gen. Hosp. No. 126402, aged 18, was referred because of delayed ado...

The treatment of hypogonadism in the adolescent male

The treatment of hypogonadism in the adolescent male