Endocrinological studies of the hypothalamo-pituitary gonadal axis during danazol treatment in pubertal boys with marked gynecomastia.
The present paper evaluates the variations of the hypothalamo-pituitary gonadal axis during Danazol treatment in pubertal boys with marked gynecomastia (breast size more than 6 cm in diameter). Before treatment a normal sleep-dependent gonadotropin increase was found together with a normal response to LHRH stimulation. Plasma prolactin increased at sleep as well. Plasma testosterone values were normal for pubertal age. During Danazol treatment 200 mg daily for 6 months basal gonadotropin levels, the sleep related hormone increases as well as the response to luteinizing-hormone releasing hormone (LHRH) stimulation were blunted. Concomitantly, testosterone values decreased to values seen in pubertal stage II-III. After 6 months of therapy, 4 of 5 boys treated so far, demonstrated a reduction of the gynecomastia to a maximum of 3 cm in diameter. In 1 boy Danazol treatment was finished after 3 months. Because of increased psychological problems a mastectomy was performed. 6 months after cessation of Danazol treatment a normal sleep dependent gonadotropin rhythm and a normal response to LHRH was found again demonstrating a normalization of the physiologic sleep-related gonadotropin rhythms. Plasma testosterone levels nearly increased to values seen before treatment. From the clinical aspect there were no signs of a recurrence of the marked pubertal gynecomastia in all boys treated with Danazol. These results indicate that Danazol is a specific gonadotropin inhibitor acting at the hypothalamo-pituitary level. No side effects on other hormones or on the development of secondary sex characteristics were noted during and after Danazol treatment.
D000293:Adolescent; D002648:Child; D003613:Danazol / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006065:Gonadotropins, Pituitary / Q000378:metabolism*; D006177:Gynecomastia / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D011245:Pregnadienes / Q000627:therapeutic use*; D011388:Prolactin / Q000378:metabolism; D011627:Puberty; D013737:Testis / Q000187:drug effects; D013739:Testosterone / Q000097:blood
D006065:Gonadotropins, Pituitary; D011245:Pregnadienes; D013739:Testosterone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D003613:Danazol