Cj. Bagatell et al., METABOLIC AND BEHAVIORAL-EFFECTS OF HIGH-DOSE, EXOGENOUS TESTOSTERONEIN HEALTHY-MEN, The Journal of clinical endocrinology and metabolism, 79(2), 1994, pp. 561-567
In addition to their use as replacement therapy for hypogonadal males,
androgens, particularly testosterone (T), are being explored as poten
tial hormonal male contraceptive agents, alone or in combination with
other compounds. Androgens have regulatory effects on a variety of phy
siological systems in addition to gonadotropin secretion and spermatog
enesis. Therefore, as hormonal contraceptive regimens that alter serum
T levels are explored, it is important to evaluate their effects on t
hese aspects of normal male physiology. The effects of exogenous T on
suppression of spermatogenesis in 19 healthy men were recently compare
d, using a T dosage of 200 mg im/week for 20 weeks. Before treatment,
the men were evaluated during a 3-month pretreatment period, and after
treatment, they were followed for 4-6 months or until their sperm cou
nts normalized. Because of the lack of information regarding the effec
ts of exogenous T on nonreproductive physiology, we examined the effec
ts of high-dose T on plasma lipids, calcium metabolism, and sexual beh
avior in our subjects. Mean serum T and estradiol levels increased sig
nificantly during the treatment period. Plasma high-density lipoprotei
n (HDL) cholesterol levels decreased significantly within the first mo
nth and remained suppressed during the duration of T administration. A
t the end of the treatment period, mean plasma HDL cholesterol had dec
reased by 13 +/- 2% (P < 0.05); plasma levels of HDL(2), HDL(3), and a
poprotein AI also decreased significantly; mean levels of low density
lipoprotein cholesterol and triglycerides were unchanged. After 1 mont
h of the recovery period, plasma HDL levels had returned to the baseli
ne range. Serum calcium levels decreased slightly during treatment; th
is decrease was statistically significant. Urinary calcium excretion d
id not change. Mean levels of serum intact PTH increased by 84 +/- 17%
(P < 0.05) during T administration; in contrast, 25-hydroxyvitamin D
levels decreased by 16 +/- 4% (P < 0.05), and 1,25-dihydroxyvitamin D
levels did not change significantly. All markers of calcium metabolism
returned to baseline during the posttreatment period. Little change w
as found in self-reported sexual and aggressive be; haviors during the
study. There was a trend toward increased arousal and spontaneous ere
ctions during T administration, but this did not reach statistical sig
nificance. Frequency of sexual intercourse, masturbation, and kissing
and fondling did not change, nor was the subjects' satisfaction in the
ir relationships affected by T administration. Mean body weight increa
sed by 4.0 +/- 0.5 kg. Approximately half the men noted mild acne. Bod
y weight and acne symptoms returned to baseline during the recovery pe
riod. These data demonstrate that the serum levels of T produced by ad
ministration of T enanthate, 200 mg im weekly, lead to suppressed leve
ls of plasma HDL cholesterol, alterations in calcium metabolism, incre
ased body weight, and in some men, mild acne. These results imply that
T enanthate at this dosage is moderately supraphysiological and may b
e inappropriately high for long-term administration to large groups of
normal men for the purpose of contraception.