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From the Centre of Reproductive Medicine and Andrology of the University,
Münster, Germany.
* Present address: Hornhaldenstr. 31 8802
Kilchberg, Switzerland.
| Correspondence to: Prof Dr med Eberhard Nieschlag, Centre of Reproductive Medicine and Andrology of the University, Domagkstr. 11, D-48129 Münster, Germany (e-mail: eberhard.nieschlag{at}ukmuenster.de). |
Interindividual differences in gonadotropin suppression achieved by short-
and long-acting intramuscular testosterone (T) preparations were studied to
detect factors hindering complete suppression of gonadotropins as the
prerequisites for effective male contraception. Forty healthy men received a
single injection of T propionate; 4 weeks later they received 2 injections of
1000 mg of T undecanoate (TU) given 6 weeks apart. Following TU, declines of
luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were
consistent in 17.5% and almost absent in 25% of men. Men showing the most
rapid and consistent declines in LH and FSH levels received a slightly higher
dose per body weight of TU (13.1 ± 0.6 vs 11.3 ± 0.6 mg/kg;
P = NS) and reached higher maximal concentrations of total T (40
± 4.8 vs 18.4 ± 2.4 nmol/L; P < .001) and free T as
well as estradiol. Men with high fat mass (mean ± SEM, 10.3 ±
1.5 vs 23.2 ± 6.4 kg) had a delayed increase in T levels and an
impaired relative decline in LH (12 ± 2% vs 53 ± 10%) and FSH
(17 ± 6%. vs 70 ± 25%) levels within the first 2 weeks after the
first TU injection. We conclude that overweight reduces the chance of rapid
and profound gonadotropin suppression during treatment with TU. Body weight
needs to be considered to avoid failure of hormonal male contraception.
Key words: Negative feedback, body weight
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