Effects of endogenous testosterone and estradiol on sexual behavior in normal young men [published erratum appears in J Clin Endocrinol Metab 1994 Jun;78(6):1520]
CJ Bagatell, JR Heiman, JE Rivier and WJ Bremner
Medical Service, Seattle Veterans Affairs Medical Center, Washington 98108.
The importance of androgens in establishing and maintaining sexual function
in males of most species is well recognized. Estrogens also stimulate male
sexual function in some species. In men, most studies of androgen effects
on behavior have used hypogonadal men as an experimental model; much less
is known about the role of endogenous testosterone (T) or estradiol (E2) in
the regulation of behavior in healthy, eugonadal men. In a randomized,
double-blind study, we used a GnRH antagonist, Nal-Glu, without T
replacement, to induce acute, profound, reversible gonadal steroid
deficiency in 9 normal men for 6 weeks (Nal-Glu alone). We also studied the
effects of partial androgen replacement by administering Nal-Glu together
with T enanthate, 50 mg im weekly, to 10 other men. A third group of 10 men
received Nal-Glu plus T, 100 mg im weekly. We studied the role of
endogenous E2 by administering Nal-Glu plus T, 100 mg im weekly, plus an
aromatase inhibitor, testolactone (Teslac), 250 mg po qid, to 10 additional
men (Nal - Glu + T + Teslac). Nine men received placebo injections and
tablets. All subjects completed a behavioral questionnaire during the
pretreatment period, at weeks 2, 4, and 6 of treatment, and at 3 weeks
posttreatment. Men who received Nal-Glu alone became profoundly hypogonadal
within 1 week after treatment began. Serum T levels did not change
significantly in the controls and in the men who received full T
replacement but decreased to approximately half the baseline level in men
who received partial T replacement. E2 levels decreased profoundly in men
who received Nal-Glu alone or Nal - Glu + T + Teslac and to a lesser degree
in men who received partial T replacement. In men who received Nal-Glu
alone, there were clinically and statistically significant decreases in the
frequency of sexual desire, sexual fantasies, and intercourse at 4-6 weeks.
These men also showed a strong trend (P = 0.55) towards decreased
spontaneous erections after 4 and 6 weeks of treatment. A significant
decrease in the frequency of masturbation was evident after 6 weeks. All
measures returned to normal by posttreatment week 3. There was a trend
toward increased aggression in the hypogonadal men, but this did not reach
statistical significance. No changes in satisfaction or happiness with
their partners were observed.(ABSTRACT TRUNCATED AT 400 WORDS)
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