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Medroxyprogesterone and paraphiles: do testosterone levels matter?

H M Kravitz1, T W Haywood, J Kelly

  • 1Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL, USA.

The Bulletin of the American Academy of Psychiatry and the Law
|January 1, 1996
PubMed
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Low pretreatment testosterone (TTS) levels in men treated with medroxyprogesterone acetate (MPA) correlated with longer treatment durations. Older age, not baseline TTS, was key in determining the time for testosterone levels to recover post-treatment.

Area of Science:

  • Endocrinology
  • Forensic Psychiatry
  • Clinical Psychology

Background:

  • Testosterone (TTS) levels are monitored in men receiving medroxyprogesterone acetate (MPA) treatment for paraphilias.
  • Understanding factors influencing TTS suppression and recovery is crucial for treatment adequacy.

Purpose of the Study:

  • To investigate associations between pretreatment testosterone (TTS) levels and patient characteristics.
  • To compare clinical responses and TTS recovery times in men with low versus normal pretreatment TTS treated with MPA.

Main Methods:

  • Naturalistic follow-up of 13 paraphilic men treated with MPA, with regular TTS monitoring.
  • Comparison of clinical response (sexual behaviors, recidivism) and time to TTS recovery between low and normal pretreatment TTS groups.

Related Experiment Videos

  • Analysis using Kaplan-Meier survival analysis and nonparametric methods; multiple regression for variable contributions.

    • Main Results:

    • Men with low pretreatment TTS received MPA for longer durations.
    • Older age was associated with a longer time for TTS levels to return to baseline after MPA discontinuation.
    • Sociodemographic, clinical, and sexual behavior data did not differentiate between low and normal TTS groups.

    Conclusions:

    • While lower pretreatment TTS may indicate sensitivity to MPA, age appears to be a more significant determinant of TTS recovery time.
    • Further research with larger samples is needed to clarify the role of TTS monitoring in MPA treatment for sex offenders.
    • The utility of TTS monitoring as a measure of treatment adequacy and predictor of outcome requires further investigation.