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Hypothalamic-pituitary-gonadal dysfunction in men using cimetidine.

D H Van Thiel, J S Gavaler, W I Smith

    The New England Journal of Medicine
    |May 3, 1979
    PubMed
    Summary
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    Cimetidine therapy significantly reduced sperm count and luteinizing hormone response in men. Prolonged use of this medication requires caution due to potential impacts on the hypothalamic-pituitary-gonadal axis.

    Area of Science:

    • Endocrinology
    • Reproductive Medicine
    • Pharmacology

    Background:

    • Cimetidine is a histamine H2 receptor antagonist.
    • Its effects on the male reproductive system are not fully understood.

    Purpose of the Study:

    • To investigate the impact of cimetidine on the hypothalamic-pituitary-gonadal axis in men.

    Main Methods:

    • Seven healthy men received cimetidine (1200 mg/day) for nine weeks.
    • Hormonal levels and responses to stimulation tests were assessed.

    Main Results:

    • A 43% mean reduction in sperm count was observed.
    • Luteinizing hormone response to GnRH was reduced.
    • Testosterone levels showed a statistically significant rise but remained lower than baseline.

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  • Gonadotropin responses to clomiphene were inadequate compared to controls.
  • Conclusions:

    • Cimetidine therapy can negatively affect male reproductive function.
    • Caution is advised for prolonged cimetidine use in young men.
    • Further research is needed to elucidate the mechanisms involved.