Pituitary function in a man with congenital aromatase deficiency: effect of different doses of transdermal E2 on basal and stimulated pituitary hormones.

[aromatase deficiency]

To clarify the role of estrogen on male pituitary function , the effects of different doses of transdermal E 2 on pituitary secretion were evaluated in a man with aromatase deficiency . The study protocol was divided into the following three phases : no E 2 treatment (phase 1 ); 25 microg transdermal E 2 twice weekly for 9 months (phase 2 );12 .5 microg transdermal E 2 twice weekly for 9 months (phase 3 ). Pituitary function was studied in detail during each phase of the study protocol by measuring hormone levels in basal conditions and after dynamic testing (GnRH , insulin tolerance test , GHRH plus arginine , TRH , and corticotropin-releasing factor ; tests ). Basal and GnRH-stimulated gonadotropin levels resulted inversely related to E 2 serum levels , according to the dosage of estrogen administered . Basal and stimulated GH , PRL , and TSH serum levels did not change during the protocol study . The secretory pituitary reserve of GH was clearly impaired . Basal and stimulated ACTH and cortisol serum levels were not modified by estrogen administration . This study demonstrated that in the human male E 2 is required at pituitary level for normal functioning of gonadotropin feedback both in basal and stimulated conditions . In this patient GH deficiency seems to be an adult-onset event since he reached a tall stature . However , the finding of a severe impairment in GH response to potent provocative stimuli together with the insensitivity of GH /IGF-I axis to circulating estrogens strongly suggest a possible involvement of estrogens on both the development and maturation of the somatotrophic axis . Finally , the congenital lack of estrogen activity seems to be associated with a slightly impaired secretion of PRL and TSH , suggesting a possible role of estrogens on the pituitary secretion of these hormones in the human male .

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Diseases presenting "male pituitary function" symptom

aromatase deficiency

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