Idiopathic hypogonadotropic hypogonadism in a male runner is reversed by clomiphene citrate.
OBJECTIVE
To assess the efficacy of estrogen antagonist therapy on the function of the hypothalamic-pituitary-testicular axis in a young male runner with significant morbidity attributable to idiopathic hypogonadotropic hypogonadism.


METHODS
An uncontrolled case study.


METHODS
The outpatient endocrinology clinic of a university tertiary referral center.


METHODS
A 29-year-old male who has run 50 to 90 miles per week since 15 years of age and who presented with a pelvic stress fracture, markedly decreased bone mineral density, and symptomatic hypogonadotropic hypogonadism.


METHODS
Clomiphene citrate (CC) at doses up to 50 mg two times per day over a 5-month period.


METHODS
Serum concentrations of LH, FSH, and T before and after CC therapy, as well as clinical indicators of gonadal function.


RESULTS
Barely detectable levels of LH and FSH associated with hypogonadal levels of T were restored to the normal range with CC therapy. The patient experienced improved erectile function, increased testicular size and sexual hair growth, and an improved sense of well being.


CONCLUSIONS
Exercise-induced hypogonadotropic hypogonadism exists as a clinical entity among male endurance athletes, and CC may provide a safe and effective treatment option for males with debilitating hypogonadism related to endurance exercise.
Burge
M R
MR
University of New Mexico School of Medicine, Department of Medicine/Endocrinology-5ACC, Albuquerque 87131, USA.
Lanzi
R A
RA
Skarda
S T
ST
Eaton
R P
RP
D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood / Q000378:metabolism; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000378:metabolism; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D007986:Luteinizing Hormone / Q000097:blood / Q000378:metabolism; D008297:Male; D012420:Running / Q000502:physiology*; D013739:Testosterone / Q000097:blood / Q000378:metabolism; D013997:Time Factors
D005300:Fertility Agents, Female; D002996:Clomiphene; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone