Some Effects of Testosterone, Testosterone Propionate, Methyl Testosterone, Stilbestrol, and X-Ray Therapy in a Patient with Cushing's Syndrome.1

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Abstract
The metabolic and clinical effects of testosterone propionate, stilbestrol, methyl testosterone and testosterone were observed under controlled conditions in a girl, aged 15, with Cushing''s syndrome. Injs. of testosterone propionate, 25 mg./day, caused a diminution in N excretion and a disappearance of creatinuria. Stilbestrol, 2-10 mg./ day, intramusc, did not affect N excretion but perhaps induced a moderate increase in creatine excretion and a decrease in creatinine excretion. Methyl testosterone, 40 mg./day, orally, caused a striking decrease in N excretion and a tremendous increase in creatine excretion. Creatinine excretion remained unaltered. Testosterone, 40 mg./day, orally, did not produce unequivocal changes in excretion of N, creatine, or creatinine. Irregular increases in 17-ketosteroid excretion, with levels as high as 26 mg./day, occurred during adm. of testosterone propionate. During recovery from this hormone and also in the period of stilbestrol adm. the 17-ketosteroid excretion averaged about 12 mg./day. Methyl testosterone caused an initial 3-day increase in 17-ketosteroids from 15 up to 25 mg., followed by a depression to levels of about 5 mg. Free testosterone caused a precipitous and marked rise in 17-ketosteroid excretion. 38-48 mg. of ketosteroid was excreted on the 40-mg. dose and over 100 mg. on the 150-mg. dose. The pattern of biochemical activity of these hormones suggests marked differences in their metabolism. The androgens induced distressing accentuation of acne, hirsutism and hypertrophy of the clitoris. Stilbestrol improved these conditions but the benefit was not striking and was associated with certain untoward reactions and a transient hyperglycemia. X-ray therapy appeared to improve the subjective and objective manifestations of the disease.