To investigate the androgen, weak androgen, estrogen, and gonadotrophi
n response to clomiphene in alcoholics, we determined in 63 male patie
nts (25 with and 38 without liver cirrhosis) serum testosterone, sexua
l hormone binding protein (SHBG), dehidroepiandrosterone, androstenedi
one, LH, FSH, prolactin, and estradiol levels, on the first and the si
xth day after admission, and after a course of 8 days of clomiphene 20
0 mg/day. The same test was performed on 15 healthy volunteers. Cirrho
tic patients showed decreased basal testosterone levels and a loss of
the circadian rhythm with recovery after clomiphene. Although basal te
stosterone levels in noncirrhotic alcoholics did not differ from those
of the controls, there was a significant improvement after withdrawal
. SHBG levels were higher in both groups of alcoholics than in control
s, pointing to a worse degree of hypogonadism, because only the free h
ormone is active. Before the clomiphene test, serum LH and FSH levels
were nonsignificantly higher in both groups of alcoholics than in the
control group. After clomiphene both LH and FSH increased. Androstened
ione and estradiol showed a (parallelism) similar behavior in alcoholi
c and in cirrhotic groups, showing in both cases higher levels than in
the control group, and an increase after clomiphene, perhaps reflecti
ng peripheral conversion of androgens to estrogens. Because clomiphene
has no effect on the adrenal cortex, the increase of androstenedione
after clomiphene points to its testicular origin (directly or after te
stosterone conversion) and not to an adrenal one. The highest serum es
tradiol levels were observed in cirrhotics with ascites or gynecomasti
a. We have not found any relation between serum hormone levels and alc
ohol intake nor with nutritional status.