Role of testosterone and dihydrotestosterone in spontaneous gynecomastia of adolescents

To test a possible hormonal mechanism of gynecomastia at puberty, a group of pubertal spontaneous gynecomastia (PSG) and healthy young volunteers (HYV), Tanner's stage II-V, were studied. Peripheral blood samples were obtained for measuring follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T), dihydrotestosterone (DHT), estradiol (E-2) and estrone (E-1). No difference was established in steroids in pituitary hormonal concentration when both groups were compared on a sexual stage-matched control basis, except for T 2 SD in 5/9 subjects of PSG and DHT 2 SD in all of PSG. The T:DHT ratio varied from 5.0 to 15.4 in PSG and from 0.42 to 2.224 in HYV. Whether spontaneous gynecomastia might exist in an enzimatic blockade of 5 alpha-reductase and whether a decrease in the T:DHT ratio might favor the estrogen action for the progression of breast enlargement deserve further analysis.

Role of stress in male fertility

Specific or non-specific noxious agents induce several disorders in body systems. In the following series some of those agents are associated with disturbances in the pituitary-testis-axis. Testicular responses which represent an adaptive mechanism to the stress may be associated with various syndromes of unexplained infertility.

[Synthetic progestogens versus oral progesterone]

The antecedents of progesterone natural hormone and related structural groups, chemically and biologically, were described. The synthesis and semi-synthesis of these compounds, is reviewed, and molecular changes, which gave more potency for clinical use, is reviewed. The pharmacology of these groups is manifested, particularly, by the identification of a receptor, its physico-quemical characteristics and relative affinity for tissues as endometrium and myometrium. Furthermore, the progestational quality, the antiestrogenic one, antiandrogenic one and its applications, were evaluated. Finally, several biologic indicators which support the use of oral progesterone and that suggest the re-evaluation of tissular dynamics in reproductive tract, were reviewed.

Sleep deprivation and adaptive hormonal responses of healthy men

To study the effects of sleep deprivation on the pituitary-testis axis physiology, we measured the circulating levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T), androstanedione (A), dihydrotestosterone (DHT), estradiol (E2), and cortisol (C) in eight healthy men as follows: phase I (control), phase II (24-h restless period), phase III (48-h restless period), and phase IV (24-h recovery period). All samples were taken at 8:00 a.m. There was a significant decrease of T, A, DHT, and E2 in phase II but no decrease in FHS, LH, PRL, or C. In phase III there was no further decrease in any androgen, although E2 decreased along with the increase of PRL. In phase IV E2 and PRL tended to return to baseline values, and the androgens were very similar to the controls. FHS, LH, and C showed no change under the effects of phase III. These data extend the adaptive androgenic response and the association of the role of E2 and PRL to restricted or disturbed sleep in men.

The biological expression of natural progesterone

Progesterone tablets were orally administered to women with no recent luteal activity. Three hypoestrogenic subjects who received, respectively, a single dose of 150 mg, 300 mg and 300 mg/d/7d, showed absorption and a progressive increase in circulating values in a dose-dependent manner. Five out of nine oligomenorrheic patients experienced withdrawal uterine bleeding with 150 mg/12/5d. Postmenopausal endometrium estrogenised by mestranol (n = 5) showed secretory histological changes after 300 mg/d/7d of oral progesterone. Six women with luteal insufficiency received 300 mg/d after control studies, and this dosage was effective in supplementing the circulating natural hormone so that it reached the level of that of fertile women. However, the endometrial progesterone uptake of these women showed no parallel increase. This study supports the clinical usage of oral progesterone and suggests evaluation of the dynamics of hormone uptake by the reproductive tissues.