RT Journal
A1 Bloch M, Rubinow DR, Berlin K, Kevala KR, Kim H, Schmidt PJ
T1 MOnoamines and neurosteroids in sexual function during induced hypogonadism in healthy men
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2006
FD April 1
VO 63
IS 4
SP 450
OP 456
DO 10.1001/archpsyc.63.4.450
UL http://dx.doi.org/10.1001/archpsyc.63.4.450
AB Context 
    Although the behavioral effects of high-dose androgen administration may involve alterations in serotonergic activity, few studies have investigated the impact of androgen withdrawal on the central nervous system in humans.Objective 
    To examine the effects of pharmacologically induced hypogonadism on several cerebrospinal fluid (CSF) systems that could mediate the behavioral concomitants of hypogonadism.Design 
    Double-blind assessment of the effects of the short-term induction of hypogonadism and subsequent replacement with testosterone and placebo in a crossover design.Setting 
    National Institutes of Health, Bethesda, Md.Participants 
    Twelve healthy male volunteers.Interventions 
    We administered the gonadotropin-releasing hormone agonist leuprolide acetate (7.5 mg intramuscularly every 4 weeks) to the healthy male volunteers, creating a hypogonadal state, and then either replaced testosterone (200 mg intramuscularly) or administered a placebo every 2 weeks for 1 month.Main Outcome Measures 
    Mood and behavioral symptoms were monitored with daily self-ratings, and lumbar punctures were performed during both hypogonadal (placebo) and testosterone-replaced conditions for CSF levels of steroids and monoamine metabolites.Results 
    The CSF testosterone, dihydrotestosterone, and androsterone levels were significantly lower during hypogonadism (P=.002, .04, and .046, respectively), but no significant changes were observed in CSF measures of 5-hydroxyindoleacetic acid, homovanillic acid, dehydroepiandrosterone, or pregnenolone. Decreased sexual interest was observed during the hypogonadal state compared with both baseline and testosterone replacement (P=.009) and correlated significantly with CSF measures of androsterone during both hypogonadism and testosterone replacement (r = −0.76 and −0.81, respectively; P<.01). Moreover, the change in severity of decreased sexual interest correlated significantly with the change in CSF androsterone levels between testosterone replacement and hypogonadism (r = −0.68; P<.05). The CSF 5-hydroxyindoleacetic acid and homovanillic acid levels did not correlate significantly with any behavioral or CSF measure.Conclusion 
    These data suggest that the neurosteroid androsterone contributes to the regulation of sexual function in men.