REVERSIBILITY OF HYPOGONADOTROPIC HYPOGONADISM ASSOCIATED WITH GENETIC HEMOCHROMATOSIS

OBJECTIVE Recent reports have suggested that hypogonadotrophic hypogon adism in men with genetic haemochromatosis can be reversed by aggressi ve venesection therapy. We have studied prospectively men with this co mplication of haemochromatosis in order to document the frequency and completeness of recovery from hypogonadism. PATIENTS AND DESIGN Six me n with symptomatic hypogonadotrophic hypogonadism and genetic haemochr omatosis were studied before beginning venesection therapy and again a fter depletion of body iron stores. MEASUREMENT Symptoms of hypogonadi sm, serum gonadotrophins and serum total and free testosterone concent rations. RESULTS Five men aged 47-66 showed no symptomatic improvement and no change in serum gonadotrophin or testosterone concentrations. The symptoms of one man, aged 33, resolved completely after venesectio n and this was accompanied by increases in serum LH and FSH. Serum tot al and free testosterone concentrations increased fourfold, but remain ed subnormal. CONCLUSION Only one partial recovery from hypogonadotrop hic hypogonadism was seen and this was in the youngest subject. In rev iewing the other documented cases of reversal it would appear that the age at diagnosis is critical and there are no proven cases of reversa l of hypogonadotrophic hypogonadism in men over the age of 40 at the s tart of venesection therapy.