The Potential for an Androgen Male Contraceptive*

Cunningham, Glenn R.; Silverman, V.; Thornby, John; Kohler, Peter O.

doi:10.1210/jcem-49-4-520

Cited by 39 publications

(11 citation statements)

References 31 publications

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“…Patients with cancer are anemic due to either malnutrition or the effect of chronic disease. Androgen therapy results in increases in hemoglobin levels (1-5 g/dl) and red blood cell volume (325-350 ml) (67,68). Before the availability of recombinant erythropoietin, refractory anemia, especially secondary to bone marrow failure, was treated successfully with androgen therapy (69).…”

Section: Therapies Currently In Use For Treatment Of Cachexiamentioning

confidence: 99%

Anabolic-Androgenic Steroid Therapy in the Treatment of Chronic Diseases

Basaria

Wahlstrom

Dobs

2001

The Journal of Clinical Endocrinology &Amp; Metabolism

231

175

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The purpose of this study was to review the preclinical and clinical literature relevant to the efficacy and safety of anabolic androgen steroid therapy for palliative treatment of severe weight loss associated with chronic diseases. Data sources were published literature identified from the Medline database from January 1966 to December 2000, bibliographic references, and textbooks. Reports from preclinical and clinical trials were selected. Study designs and results were extracted from trial reports. Statistical evaluation or meta-analysis of combined results was not attempted.Androgenic anabolic steroids (AAS) are widely prescribed for the treatment of male hypogonadism; however, they may play a significant role in the treatment of other conditions as well, such as cachexia associated with human immunodeficiency virus, cancer, burns, renal and hepatic failure, and anemia associated with leukemia or kidney failure. A review of the anabolic effects of androgens and their efficacy in the treatment of these conditions is provided. In addition, the numerous and sometimes serious side effects that have been known to occur with androgen use are reviewed.Although the threat of various side effects is present, AAS therapy appears to have a favorable anabolic effect on patients with chronic diseases and muscle catabolism. We recommend that AAS can be used for the treatment of patients with acquired immunodeficiency syndrome wasting and in severely catabolic patients with severe burns. Preliminary data in renal failure-associated wasting are also positive. Advantages and disadvantages should be weighed carefully when comparing AAS therapy to other weight-gaining measures. Although a conservative approach to the use of AAS in patients with chronic diseases is still recommended, the utility of AAS therapy in the attenuation of severe weight loss associated with disease states such as cancer, postoperative recovery, and wasting due to pulmonary and hepatic disease should be more thoroughly investigated. (J Clin Endocrinol Metab 86: 5108 -5117, 2001)

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Section: Therapies Currently In Use For Treatment Of Cachexiamentioning

confidence: 99%

Anabolic-Androgenic Steroid Therapy in the Treatment of Chronic Diseases

Basaria

Wahlstrom

Dobs

2001

The Journal of Clinical Endocrinology &Amp; Metabolism

231

175

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“…There is also functional evidence for the presence of androgen receptors in the pituitary and perhaps the hypothalamus of humans, based on administration of antiandrogens to normal men. For example, when flutamide (or another antiandrogen) is administered, increases occur in serum luteinizing hormone and testosterone (45)(46)(47)(48), and treatment with testosterone suppresses serum luteinizing hormone (49,50).…”

Section: Discussionmentioning

confidence: 99%

Quality of Life in Advanced Prostate Cancer: Results of a Randomized Therapeutic Trial

et al. 1999

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Background: For patients with metastatic prostate cancer, treatment is primarily palliative, relying mainly on the suppression of systemic androgen hormone levels. To help document the achievement of palliation and to characterize positive and negative effects of treatment, we evaluated qualityof-life (QOL) parameters in patients with metastatic prostate cancer who were randomly assigned to two methods of androgen deprivation. Methods: Patients (n = 739) with stage M 1 (bone or soft tissue metastasis) prostate cancer were enrolled in a QOL protocol that was a companion to Southwest Oncology Group INT-0105, a randomized doubleblind trial comparing treatment with bilateral orchiectomy (surgical castration) plus either flutamide or placebo. Patients completed a comprehensive battery of QOL questionnaires at random assignment to treatment and at 1, 3, and 6 months later. Data were collected on three treatment-specific symptoms (diarrhea, gas pain, and body image), on physical functioning, and on emotional functioning. All P values are two-sided. Results: Questionnaire return rates for this study never dropped below 80%; only 2% of the patients did not submit baseline QOL assessments. Cross-sectional analyses (corrected for multiple testing) identified statistically significant differences that favored orchiectomy plus placebo for two of the five primary QOL parameters as follows: patients receiving flutamide reported more diarrhea at 3 months (P = .001) and worse emotional functioning at 3 and 6 months (both P<.003). Longitudinal analyses replicated these findings. Other analyzed QOL parameters favored the group receiving placebo but were not statistically significant after adjustment for multiple testing. Conclusions: We found a consistent pattern of better QOL outcomes at each follow-up assessment during the first 6 months of treatment for orchiectomized patients with metastatic prostate cancer who received placebo versus flutamide. Improvement over time was evident in both treatment groups but more so for patients receiving placebo. [J Natl Cancer Inst 1998;90:1537-44]

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“…These effects appear to be reversible; even in bodybuilders using high doses of anabolic steroids for long periods, sperm production may return to normal when androgen use is discontinued (Knuth et al 1989). Attempts have been made to use these properties of androgens for the development of male contraceptives (Cunningham et al 1979;Knuth et al 1989;Matsumoto 1988). Attempts have been made to use these properties of androgens for the development of male contraceptives (Cunningham et al 1979;Knuth et al 1989;Matsumoto 1988).…”

Section: Effects On Gonadotropins Spermatogenesis and Sexual Functionmentioning

confidence: 99%

“…17 a-alkylated oral androgens can also depress the secretion of gonadotropin and testosterone (Vigerski et al 1976), and possibly reduce the pituitary response to gonadotropin-releasing hormone. A problem so far has been that sperm production is not completely inhibited in all cases, and that sideeffects (such as polyglobuly, weight increase and acne) may develop in rare cases (Cunningham et al 1979). A problem so far has been that sperm production is not completely inhibited in all cases, and that sideeffects (such as polyglobuly, weight increase and acne) may develop in rare cases (Cunningham et al 1979).…”

Section: Effects On Gonadotropins Spermatogenesis and Sexual Functionmentioning

confidence: 99%

“…This results from a direct effect on the bone marrow (Mirand and Murphy 1971;) and from enhancement of erythropoietin production, even in anephric patients (Naets and Wittek 1968;Shahidi 1973). When normal men are treated with pharmacological doses of testosterone esters, haemoglobin increases by about 1 g/dl (Cunningham et al 1979); in women the increase is about 4.3 g/dl (Kennedy and Gilbertsen 1957). Improvements in patients with aplastic anaemia or other forms of bone marrow failure can be dramatic (Najean 1981); however, the clinical use of androgens to stimulate erythropoiesis in uraemics and in patients with aplastic anaemia must now be considered obsolete due to the availability of synthetic human erythropoietin, which has fewer side-effects than androgens; although, at this time, the costs of erythropoietin treatment are still high.…”

Section: Haematopoietic Systemmentioning

confidence: 99%

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Testosterone

1990

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The Potential for an Androgen Male Contraceptive*

Cited by 39 publications

References 31 publications

Anabolic-Androgenic Steroid Therapy in the Treatment of Chronic Diseases

Anabolic-Androgenic Steroid Therapy in the Treatment of Chronic Diseases

Quality of Life in Advanced Prostate Cancer: Results of a Randomized Therapeutic Trial

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