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Glucocorticoids: their role on gonadal function and LH secretion
L N Contreras1, A M Masini, M M Danna
1Departamento de Endocrinología Instituto de Investigaciones Médicas Dott. Alfredo Lanari, UBA, Argentina.
Minerva Endocrinologica
|June 1, 1996
Summary
Chronic glucocorticoid (GC) therapy in men lowers testosterone levels, impacting gonadal function. However, luteinizing hormone (LH) reserve remains normal, suggesting the pituitary response is preserved.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Pharmacology
Background:
- Glucocorticoids (GCs) are widely used for their anti-inflammatory and immunosuppressive properties.
- Chronic administration of supraphysiological GC doses can lead to adverse effects on endocrine function.
- The impact on gonadal function and luteinizing hormone (LH) reserve requires further investigation.
Purpose of the Study:
- To assess gonadal function and LH reserve in men undergoing chronic therapy with supraphysiological GC doses.
- To evaluate the effects of GC therapy on testosterone levels and sexual health.
- To determine the pituitary's response to gonadotropin-releasing hormone (GnRH) stimulation.
Main Methods:
- Clinical evaluation of 17 male subjects on chronic GC therapy.
- Measurement of sex hormone-binding globulin (SHBG), total, free, and bioavailable testosterone.
- Gonadotropin-releasing hormone (GnRH) stimulation test with LH level assessment.
- Comparison with four healthy male controls.
Main Results:
- Patients reported decreased libido (58%) and impotence (52%).
- Significantly lower total, free, and bioavailable testosterone levels were observed compared to controls (p < 0.01, p < 0.05, p < 0.05).
- SHBG levels remained unchanged, and baseline and stimulated LH secretion were normal.
Conclusions:
- Chronic supraphysiological GC administration impairs gonadal function by reducing sexual steroids.
- LH secretion, both baseline and stimulated, is not affected by chronic GC therapy.
- Priming with physiological GnRH doses enhances pituitary responsiveness to higher GnRH doses.