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Effects of Leuprolide-Induced Hypogonadism and Testosterone Replacement on Sleep, Melatonin, and Prolactin Secretion in Men

Clinical Psychobiology Branch (E.L., E.H.T., S.B.A., T.A.W.) and the Behavioral Endocrinology Branch (P.J.S., M.A.D., D.R.R.), National Institute of Mental Health, Bethesda, Maryland 20892

Address all correspondence and requests for reprints to: Dr. Ellen Leibenluft, Room 4S-239, 10 Center Drive, MSC 1390, Bethesda, Maryland 20892-1390.

The possible role of gonadal steroids in regulating sleep and circadian rhythms in humans has received relatively little attention despite the importance of the topic to several clinical syndromes. Pharmacologically induced hypogonadism, with and without gonadal steroid replacement, provides an opportunity to examine these questions within a controlled experimental design. We used leuprolide acetate, with and without testosterone replacement, to study the role of testosterone in the regulation of sleep and of melatonin, PRL, and TSH secretion in men. Results from 10 men revealed significant decreases in 24-h PRL levels and in the percentage and time of stage 4 sleep in the hypogonadal state compared with testosterone replacement. There were no differences in melatonin or TSH secretion or in the timing or duration of sleep between the two hormonal conditions. These results indicate that testosterone has relatively specific and discrete effects on sleep and hormonal rhythms in men.

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