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Clomiphene fails to revert hypogonadism in most male patients with conventionally treated nonfunctioning pituitary

Rogerio Silicani Ribeiro1, Julio Abucham

  • 1Neuroendocrine Unit, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brazil.

Arquivos Brasileiros De Endocrinologia E Metabologia
|July 23, 2011
PubMed
Abstract

Insights

Clomiphene treatment in men with hypogonadism and nonfunctioning pituitary adenomas (NFPA) showed limited success. Most patients experienced decreased testosterone levels, indicating clomiphene is not a reliable treatment for this condition.

Area of Science:

  • Endocrinology
  • Reproductive Medicine

Background:

  • Hypogonadism is common in men with nonfunctioning pituitary adenomas (NFPA).
  • Conventional treatments for NFPA may not fully restore testicular function.

Purpose of the Study:

  • To evaluate the efficacy of clomiphene citrate in treating hypogonadism in men with previously treated NFPA.

Main Methods:

  • An open-label, single-arm, prospective trial involving nine hypogonadal men with NFPA.
  • Patients received 50 mg of clomiphene daily for 12 weeks.
  • Hormone levels (testosterone, estradiol, LH, FSH, prolactin) and erectile function were monitored.

Main Results:

  • Only one patient showed improvement in testosterone and erectile function.
  • Eight patients experienced a decrease in testosterone levels.
  • Luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol levels remained unchanged.
  • Insulin sensitivity improved in patients unresponsive to clomiphene.

Conclusions:

  • Clomiphene treatment was largely ineffective in restoring normal testosterone levels in men with hypogonadism and NFPA.
  • This contrasts with the success of dopaminergic therapy in hypogonadal men with prolactinomas.

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