title: Estradiol levels in men with congenital hypogonadotropic hypogonadism and the effects of different modalities of hormonal treatment.
abstract: OBJECTIVE
  To evaluate the degree of E2 deficiency in male congenital hypogonadotropic hypogonadism (CHH), and its response to different hormonal treatments.
  
  
  METHODS
  Retrospective and prospective studies.
  
  
  METHODS
  Academic institution.
  
  
  METHODS
  Untreated or treated CHH, healthy men, untreated men with Klinefelter syndrome (KS).
  
  
  METHODS
  Serum sex hormone-binding globulin (SHBG) and total E2 (TE2) as well as bioavailable (BE2) and free (FE2) levels were measured and determined.
  
  
  METHODS
  Total, bioavailable, and free testosterone, TE2, BE2, FE2 were compared in normal men, untreated and treated CHH and in untreated KS.
  
  
  RESULTS
  TE2, BE2, and FE2 levels were very significantly lower in untreated patients with CHH (n=91) than in controls (n=63) and in patients with KS (n=45). The TE2 correlated positively with serum total T in patients with CHH. The TE2 also correlated very positively with serum LH in the combined population of patients with CHH and healthy men, suggesting that low E2 levels in CHH are due to severe LH-driven T deficiency. All fractions of circulating E2 were very significantly higher in patients with CHH receiving T enanthate (n=101) or the FSH-hCG combination (n=88) than in untreated patients with CHH. Contrary to dihydrotestosterone (DHT), both T enanthate and combined FSH-hCG therapy significantly and prospectively increased TE2 levels in patients with CHH.
  
  
  CONCLUSIONS
  Contrary to KS, the male hypogonadism observed in CHH is associated with profound E2 deficiency, which can be overcome by aromatizable androgen or combined gonadotropin therapy.
authors.affiliation: Paris-Sud University, Faculté de Médecine Paris-Sud, Laboratoire de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Séverine
authors.initials: S
authors.lastname: Trabado
authors.forename: Luigi
authors.initials: L
authors.lastname: Maione
authors.forename: Sylvie
authors.initials: S
authors.lastname: Salenave
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Baron
authors.forename: Françoise
authors.initials: F
authors.lastname: Galland
authors.forename: Hélène
authors.initials: H
authors.lastname: Bry-Gauillard
authors.forename: Anne
authors.initials: A
authors.lastname: Guiochon-Mantel
authors.forename: Philippe
authors.initials: P
authors.lastname: Chanson
authors.forename: Nelly
authors.initials: N
authors.lastname: Pitteloud
authors.forename: Antonio Agostino
authors.initials: AA
authors.lastname: Sinisi
authors.forename: Sylvie
authors.initials: S
authors.lastname: Brailly-Tabard
authors.forename: Jacques
authors.initials: J
authors.lastname: Young
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000728:Androgens / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D013196:Dihydrotestosterone / Q000008:administration & dosage*; D004958:Estradiol / Q000097:blood / Q000172:deficiency*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000151:congenital / Q000188:drug therapy*; D007713:Klinefelter Syndrome / Q000097:blood / Q000188:drug therapy; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D010297:Paris; D011446:Prospective Studies; D012189:Retrospective Studies; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000172:deficiency; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000728:Androgens; D015415:Biomarkers; D006063:Chorionic Gonadotropin; D012738:Sex Hormone-Binding Globulin; D013196:Dihydrotestosterone; D013739:Testosterone; D004958:Estradiol; C004648:testosterone enanthate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone