Plasma testosterone profiles in Cushing's syndrome

Area of Science:

• Endocrinology
• Reproductive Medicine

Background:

• Cushing's syndrome is a hormonal disorder caused by prolonged exposure to high cortisol levels.
• It can result from adrenal hyperplasia, adenoma, or exogenous steroid use.
• Reproductive and sexual disturbances are common in Cushing's syndrome.

Purpose of the Study:

• To investigate the role of adrenal glands in regulating plasma testosterone levels in patients with Cushing's syndrome.
• To correlate testosterone levels with specific symptoms like menstrual irregularities, hirsutism, and impotence.

Main Methods:

• Measurement of plasma testosterone and cortisol levels.
• Assessment of testosterone and cortisol response to dexamethasone suppression and ACTH stimulation.
• Evaluation of testosterone levels before and after adrenalectomy or adenotomy.

Main Results:

• Women with Cushing's disease showed elevated plasma testosterone, correlating with menstrual irregularities and hirsutism.
• Men with Cushing's syndrome exhibited lowered plasma testosterone, with some reporting impotence.
• Adrenalectomy or adenotomy normalized testosterone levels in both sexes.
• Dexamethasone suppressed testosterone in women with Cushing's disease, indicating adrenal origin.

Conclusions:

• Adrenal hyperandrogenism contributes to sexual and gonadal disturbances in women with Cushing's syndrome.
• Glucocorticoid-induced suppression of Leydig cell function may explain low testosterone in men with Cushing's syndrome.