Influence of major surgical stress on plasma testosterone, plasma LH and urinary steroids

Alterations of neuroendocrine functions in spinal cord injury

A transverse myelopathy causes a marked dysfunction in the negative feedback of some of the hypothalamo-hypophyseal-target organ axes. Spinal cord injured (SCI) humans with lesions above T6 exhibit significantly lower serum LH and testosterone but not FSH. The parathyroid hormone-thyrocalcitonin regulation of bone metabolism is disturbed; the higher the lesion, the greater is the loss of mineral and matrix components of the bone. Further, the response to insulin induced hypoglycemia is blunted in SCI with high lesions, and their basal levels of norepinephrine, epinephrine, and cortisol are significantly lower than those of controls. Distension of the bladder or rectum, however, produces marked release of norepinephrine and concomitant increase in sympathetic activity. The results suggest impaired hypothalamo-hypophyseal-testicular, -adrenocortical, - adrenomedulary, -sympathetic axis dysfunction.

Effects of psychological stress on male reproduction: a review

Many forms of stress, including psychological, can affect male fertility and reproduction. The autonomic nervous system and the adrenal hormones participate in the classic stress response while also affecting the reproductive system. Evidence exists that mild-to-severe emotional stress depresses testosterone and perhaps interferes with spermatogenesis in the human male. There are difficulties, however, in attributing individual cases of infertility to psychological factors without evidence of psychopathology. In animals social stress, high altitude, surgery, and immobilization stress affect body weight, testosterone levels, and copulatory behavior with variable effects on testicular morphology. Stress applied to the pregnant rat also affects the development and sexual behavior of the male offspring. This literature is reviewed and discussed in terms of the usefulness of animal models and suggested future research.

Diurnal variations of pituitary and testicular hormones in paraplegic men

The effect of the neuro-spinal cord injury upon testicular physiology was evaluated in six adult paraplegic (PPG) men by measuring the circulating levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), androstenedione, testosterone, and dihydrotestosterone every 4 hr throughout a 24-hr period. Three PPG men were studied within the first 3 months (acute period) and the other three patients 39-79 months (stabilized period) after trauma. Hormonal values were compared with eight age-matched normal adult males. Plasma FSH and LH were constantly above normal concentrations regardless of the sampling time and period of observation, whereas prolactin was higher than normal only during the first two months after trauma, returning to normal afterwards. Plasma androgens were consistently below normal during the first 3 months after injury, and returned toward normal thereafter. There may be a direct relationship between the time elapsed after the spinal cord injury and the plasma androgens concentrations. A possible role of PRL in testicular steroidogenesis is suggested.

Effect of surgical stress on pituitary-testicular function

The effect of surgical stress on the secretions of LH, FSH, testosterone (T) and oestradiol (E2) were studied in twelve male patients. During surgery LH rose significantly; post-operatively, LH fell but remained persistently elevated a week after operation. However, T and E2 fell progressively to a nadir on the second and fifth post-operative day respectively and remained suppressed. Serum FSH showed no significant change. Despite a post-operative decrease in sex hormone binding globulin (SHBG) binding capacity, non-SHBG bound T showed a decrease parallel to T. Multiple sampling studies showed that the secretions of LH were increased and that of T were decreased post-operatively. Following surgery, LH responses to LHRH were magnified, FSH and T responses showed no significant change when compared with the pre-operative responses. These data suggest that secretions of LH were increased during surgery. Following surgical stress, T and E2 concentrations were suppressed resulting in a compensatory elevation of LH concentrations.