title: Idiopathic hypogonadotropic hypogonadism in a male runner is reversed by clomiphene citrate.
abstract: 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.
authors.affiliation: University of New Mexico School of Medicine, Department of Medicine/Endocrinology-5ACC, Albuquerque 87131, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Burge
authors.forename: R A
authors.initials: RA
authors.lastname: Lanzi
authors.forename: S T
authors.initials: ST
authors.lastname: Skarda
authors.forename: R P
authors.initials: RP
authors.lastname: Eaton
mesh_terms: 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
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone