TESTOSTERONE ENANTHATE AT A DOSE OF 200 MG WEEK DECREASES HDL-CHOLESTEROL LEVELS IN HEALTHY-MEN/

The concept that androgen alone can provide an effective male contrace ptive has been tested in a multicentre, multiphase trial by the World Health Organization. Results from this trial showed that an eater of t estosterone, testosterone enanthate (TE), administered at a dose of 20 0 mg/week, has a very high contraceptive efficacy, and suggested that, at least in some populations, androgen alone might provide a viable o ption for the control of male fertility. It has been claimed that test osterone represents one of the gender-related risk factors for coronar y artery disease (CAD) in men. Epidemiological and interventional stud ies have failed to establish a convincing relationship between testost erone and high density lipoprotein cholesterol (HDL-C). Therefore, the re is concern about possible negative effects on lipoprotein asset of an androgen-alone male contraceptive. In this study we analysed the ef fects of long-term (12 months) administration of TE (200 mg/week) in n ormal healthy men. Blood samples (six men >10 h fast = Group 1; 30 men >4 h fast = Group 2) were drawn from 36 men, monthly before the begin ning of the injections (control), every 3 months throughout the study period (treatment), and 1 month after stopping TE injections (recovery ). Total cholesterol (chol), triglycerides, HDL-C and LDL-C levels wer e measured in these samples. Biochemical parameters were also monitore d. TE administration induced a significant decrease (15-20%) in HDL-C levels that was of comparable magnitude in men from both groups (fasti ng and non-fasting) and occurred regardless of basal HDL-C levels. No statistically significant effect on other lipoproteins was detected. C onsidering all men together, HDL-C levels were decreased in 78% of the men by month 3, 83% by month 6, 94% by month 9 and 97% by month 12 of treatment. In all men the HDL-C decrease was reversible within 1 mont h of stopping TE administration. It is concluded that: (1) injection o f 200 mg TE/week causes a 15-20% decrease in HDL-C in normal men with no effect on other lipoproteins, (2) the suppressive effect of TE is m aintained throughout the 1-year-injection period, and a direct relatio nship between the duration of TE administration and the proportion of men showing decreased HDL-C levels, was observed. (3) The HDL-C decrea se was reversible within 1 month of stopping TE administration. These data will be important in designing further studies on male contracept ion, and in interpreting the relationship between testosterone levels, HDL-C levels and potential cardiovascular risk.