Endocrine effects of oestrogen withdrawal in long-term treated patients with prostatic adenocarcinoma.
Eighteen patients with prostatic adenocarcinoma, treated with oestrogen for 45 months or more, were followed-up after withdrawal of oestrogen treatment. Serum concentrations of testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), oestradiol-17 beta, testosterone-oestradiol-binding globulin (TeBg) and prolactin were measured at different intervals between 3 and 42 months after cessation of treatment. Serum testosterone concentrations after cessation of oestrogen treatment were low (range 71.4 +/- 6.3 to 120.8 +/- 23.7 nmol/100ml), whereas the concentrations of LH (range 21.8 +/- 3.6 to 32.6 +/- 9.1 U/1) and FSH (range 31.2 +/- 5.5 to 54.7 +/- 9.5 U/1) were within or higher than the reference range. Prolactin (range 6.0 +/- 85.3 to 7.9 +/- 68.2 micrograms/1) was within the reference range. No significant changes in serum concentrations of testosterone, LH, FSH and prolactin occurred during the follow-up period. The serum concentrations of both oestradiol-17 beta and TeBg, found between 13 and 36 months after oestrogen cessation (range 43.8 +/- 4.6 to 46.2 +/- 5.9 and 64.0 +/- 2.5 to 86.0 +/- 10.0, respectively) were significantly lower than the concentrations found between 3 and 12 months (range 71.9 +/- 10.4 to 99.8 +/- 12.9 and 124.1 +/- 15.5 to 140.2 +/- 13.7, respectively). It is concluded that in patients with prostatic adenocarcinoma, long-term oestrogen treatment causes an irreversible impairment of Leydig cell function and consequently a reduced testosterone secretion after cessation of oestrogen treatment.
Tomić
R
R
Department of Urology, University of Umeå, Sweden.
Damber
J E
JE
Bergman
B
B
D000230:Adenocarcinoma / Q000188:drug therapy*; D000368:Aged; D004958:Estradiol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D004997:Ethinyl Estradiol / Q000009:adverse effects* / Q000627:therapeutic use; D006065:Gonadotropins, Pituitary / Q000097:blood; D006801:Humans; D007985:Leydig Cells / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013375:Substance Withdrawal Syndrome / Q000378:metabolism*; D013739:Testosterone / Q000097:blood; D013997:Time Factors
D006065:Gonadotropins, Pituitary; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D004997:Ethinyl Estradiol; D004958:Estradiol; C008958:polyestradiol phosphate