MEDROXYPROGESTERONE AND PARAPHILES - DO TESTOSTERONE LEVELS MATTER

We examine the associations between pretreatment testosterone (TTS) le vels and sociodemographic, clinical, and sexual behavioral characteris tics. Two groups, low and normal pretreatment TTS, were treated with m edroxyprogesterone acetate (MPA) and compared on clinical response (de viant and nondeviant sexual behaviors; recidivism) and length of time to return to pretreatment TTS after discontinuing MPA, Thirteen paraph ilic men who were treated with MPA and had TTS levels monitored at app roximately three-month intervals during and after MPA were followed na turalistically. The principal outcome measures pertained to TTS levels and data from a self-report psychosexual inventory, which quantified deviant and nondeviant sexual activities, Time to return to baseline T TS levels were analyzed with Kaplan-Meier survival analysis, Nonparame tric methods were used to compare the two groups on other variables, M ultiple regression was used to examine the contribution of combination s of variables to TTS outcome, Subjects with low pretreatment TTS rece ived MPA for longer periods of time, and older subjects took longer to return to pretreatment TTS levels despite being treated for shorter p eriods of time, Although subjects with lower pretreatment TTS levels m ay be more sensitive to MPA's TTS-suppressive effects, the multiple re gression analysis showed that age may be an important determinant of t he time it takes for TTS levels to return to pretreatment baseline, So ciodemographic, clinical, and self-reported measures of sexual behavio r did not distinguish between low and normal TTS level groups, Only on e relapse was detected, Further studies with larger samples are requir ed to better understand the role of TTS monitoring of sex offenders tr eated with MPA, in order to justify its continued use as a measurement of treatment adequacy and to study its potential role as a predictor of treatment outcome.