Effect of Male Hormone Therapy on Urinary Gonadotropins in Man1

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Abstract
Men with primary testicular insufficiency excrete amts. of urinary gonadotrophins generally greater than those of normal men. Both individual and day to day variations are considerable, the range of values being from near normal to 8 or 10-fold normal. Testosterone propionate administered in therapeutic dosages reduced the excretion of urinary gonadotrophins to undetectable amts. (less than 6 m.u. per 24 hrs.). Significant diminution of gonadotrophic hormone excretion occurred within 10 to 13 days after the beginning of treatment, and with continued treatment the urine remained free of gonadotrophins for as long as the study continued (10 mos.). Following cessation of 3-mo. courses of andro-genic therapy, gonadotrophic titers rose to levels observed prior to treatment, detectable amts. being seen after 7 to 13 days. Thus no permanent impairment of this mechanism was demonstrated. There was no evidence of a direct relation between gonadotrophic titers and the incidence of hot flushes or vasomotor instability in men with primary testicular insufficiency. Although in one case 30 mg. of testosterone propionate was required for clinical benefit and control of excessive excretion of gonadotrophins this was usually accomplished with a daily dose of 20 mg. of testosterone propionate injected intramusc. in 1.0 cc. of peanut oil. This dose was about 4/5 of that usually recommended. Control of symptoms and gonadotrophic excretion was obtained in one castrate patient with 70 mg. daily of methyl testosterone administered orally.