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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
.
Diseases
Validation
Diseases presenting
"pituitary secretion of these hormones in the human male"
symptom
aromatase deficiency
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