[Hormonal treatments for disorders of sexual conduct]

Because of the limits of justice, our society turns itself towards the medical need and demands efficient treatments. Mutilating neuro-surgery and treatment with estrogens have been used and then stopped. Medroxyprogesterone (MPA) and Cyproterone (CPA) acetate have been proved to be efficient in 80% of cases studied and published. However the therapeutic use of CPA is limited in France by three drawbacks: exclusive oral route of administration, lack of available biological criteria as a control of good observance and lack of official indication. Therefore the authors studied a GnRH analogue (triptorelin) which induces a reversible hormonal castration and which is administered by I.M. route monthly. It was efficient in five out of six aggressive hypersexual patients. An ethical study is proposed after which the authors call for an evolution of the mentalities about this question.