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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Testosterone plus Nandrolone = Estrogen overload?
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<blockquote data-quote="madman" data-source="post: 212320" data-attributes="member: 13851"><p>Might want to renege on that one!</p><p></p><p><em><strong>*In all five volunteers levels of LH, FSH, and testosterone were reduced throughout treatment; <u>prolactin levels were unchanged </u>(fig 2).</strong></em></p><p></p><p></p><p></p><p></p><p><strong>REVERSIBLE AZOOSPERMIA INDUCED BY THE ANABOLIC STEROID 19-NORTESTOSTERONE (1984)</strong></p><p><strong></strong></p><p><strong>Subjects and Methods </strong></p><p></p><p><em>Five healthy men aged 21-25 years consented to participate in the study after receiving extensive information about its aims and risks, in accordance with German drug regulations. None of the subjects had ever had any serious disease. All were active in sports and, aware that they were receiving an anabolic steroid, undertook heavy physical training during the treatment phase. The subjects had stable sexual relations during the investigation.</em></p><p><em></em></p><p><em><strong>Physical examination, clinical chemistry, hematology, serum levels of the hormones luteinizing hormone (LH), follicle-stimulating hormone (FSH), <u>prolactin</u>, and testosterone, and semen analysis (sperm density, motility, morphology, and seminal fructose) were carried out twice during the control period (A and B): all results were normal. </strong>All subjects’ spermatozoa were functionally intact as assessed in the heterologous ovum penetration test.8,9</em></p><p></p><p><strong><em>The subjects were given intramuscular. injections of 19- nortestosterone-hexoxyphenylpropionate (Pharmaleo, Ratingen, West Germany), for the <u>first 3 weeks 100 mg per week, then two 100 mg injections per week for a further 10 weeks</u>.</em></strong><em> Throughout the study, the subjects were examined physically, and body weight and testicle and prostate size (as assessed by orchidometer and rectal palpation, respectively) were recorded.<strong> Blood samples for endocrine measurements were taken at the end of every week before administration of the next dose, as well as 1, 4, 8, 16, and 20 weeks after the last injection.</strong> Clinical chemistry was repeated in weeks 2, 5, 8, and 11 of treatment and 1, 4, 8, 12, 16, and 20 weeks after treatment. Ejaculates were obtained during weeks 4, 7, 11, 12, and 13 of treatment. All subjects were followed up for 16 weeks. Seminal parameters had then returned to normal in two subjects. The remaining three were followed up to week 24.</em></p><p><em></em></p><p><em>Semen evaluation was carried out according to World Health Organisation guidelines. 10 The subjects were requested to abstain from sexual activity for 48 h-7 days before the investigation (48 h in most cases). Testosterone was isolated from serum and separated from 19-nortestosterone by high-performance liquid chromatography, then measured by radioimmunoassay. 1,12 Reagents s provided by the WHO Matched Reagents Programme were used for measurement of serum LH by radioimmunoassay. FSH (IRE, Dusseldorf, West Germany) and prolactin (Serono, Freiburg, West Germany) were measured with commercially available radioimmunoassay kits.</em></p><p><em></em></p><p><em>All results, expressed as mean±SEM, were analyzed by Student’s s paired t-test with the means of the two control values (A and B) as points of reference.</em></p><p></p><p></p><p></p><p></p><p><strong>Results</strong></p><p><strong></strong></p><p><strong><em>None of the five volunteers complained of any discomfort during the study and there were no effects on general health, <u>no gynecomastia, and no acne</u>. Prostate size did not change. <u>Libido and potency as reported in weekly interviews were unaltered</u>. Testicular volumes fell from 39±3 ml to 21<strong><em>±</em></strong>3 ml at the end of treatment but returned to the original volume 16 weeks after treatment (fig 1).</em></strong> Bodyweight (87.5<em>±</em>0.9 kg at the beginning of the study) increased continuously to 94.0<em>±</em>1.9 kg at the end of treatment; 16 weeks after treatment it had fallen to 92.0±2.6 kg.</p><p></p><p><em><strong>In all five volunteers levels of LH, FSH, and testosterone were reduced throughout treatment; <u>prolactin levels were unchanged </u>(fig 2). </strong>FSH and LH remained below control levels until 8 and 16 weeks after treatment, respectively, and FSH was significantly above the control level at week 16. Serum testosterone concentrations returned to normal even more slowly, reaching control levels 6 months after the last injection.</em></p><p><em></em></p><p><em>Azoospermia was first observed in one subject after 7 weeks’ treatment, and by week 13 all five men were azoospermic (fig 3). Azoospermia persisted for 4 to 14 weeks after treatment. However, the volunteer who first became azoospermic had 0 - 2 million sperm per ml in the first post-treatment week. Seminal measurements had returned to normal 8 weeks after treatment in one subject, 14 weeks in another, and 20 weeks in two. In the fifth subject, recovery was slow; 24 weeks after treatment the sperm concentration was still only 1 million/ml. (However, when subject 5 was investigated 30 weeks after treatment, all his seminal parameters had returned to normal: 33 million sperm/ml, 75% motile sperm, 51% normally formed sperm.) Whenever the heterologous ovum penetration test could be done the sperm were classified as functionally normal, except in subject 5 after 11 weeks’ treatment, when only 3% of the hamster eggs were penetrated (lower normal limit 10%). Ejaculate volumes and seminal fructose concentrations did not change significantly during the study (fig 1).</em></p><p><em></em></p><p><em>Serum levels of alanine and aspartate aminotransferases and lactate dehydrogenase were significantly raised on one or two occasions, whereas y-glutamyl transpeptidase, alkaline phosphatase, and bilirubin did not rise above control levels (see table). Creatinine was raised on four occasions, but uric acid, cholesterol, and protein did not change significantly. </em><strong><em>The reticulocyte count slowly increased and reached peak values 4 weeks after the last injection: the highest erythrocyte count, hemoglobin, and hematocrit values occurred in weeks 8 and 12.</em></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>Discussion</strong></p><p></p><p><em>19-nortestosterone is one of the most widely used anabolic steroids, both in clinical medicine and in athletics. It is surprising that this</em> well-known steroid, which has been used for more than 20 years without reports of serious toxic side-effects,<em> has these drastic effects on spermatogenesis. Possible explanations are that cachectic or convalescent patients receiving this steroid are not likely to be primarily interested in reproduction and that the testicular function of athletes taking the steroids secretly has never been thoroughly investigated. The dosage we tested is somewhat higher than that usually given to patients (50 mg/month to 100 mg/week) but is still lower than the quantities occasionally injected by athletes on the assumption that the drug will improve performance in competition.</em></p><p><em></em></p><p><em>After 7-12 weeks’ treatment up to 4-14 weeks after the end of treatment the subjects could be considered infertile. The periods of azoospermia lasted for 5-20 weeks if the sperm concentration of 0 • 2 million/ml in one subject in the first post-treatment week is disregarded. The suppression of spermatogenesis is apparently caused by suppression of pituitary gonadotropins secretion. In contrast to Bijlsma et al,13 who described a fall in FSH and testosterone but not LH with 19-nortestosterone, we found simultaneous falls in LH, FSH, and testosterone.</em></p><p><em></em></p><p><em><strong>Despite reduced testosterone levels none of our subjects reported a loss of libido or potency. This observation, together with the fact that prostate size, ejaculate volume, and seminal fructose levels did not change, indicates that 19-nortestosterone given in such doses has sufficiently high androgenic potency. In contrast, neither prostate hypertrophy nor acne, which would be expected with a similar testosterone dosage, developed. Therefore, the androgenic properties of 19-nortestosterone seem to be lower than those of testosterone. <u>19-nortestosterone itself does not bind to estrogen receptors14 and is poorly converted to estrogens</u>. These facts may account for the lack of acne and gynecomastia in our subjects.</strong></em></p><p><em></em></p><p><em>The long-lasting suppression of serum LH, FSH, and testosterone after treatment indicates that 19-nortestosterone must remain in the body for some time. This finding may also explain why recovery of seminal parameters, at least in one subject, was very slow. However; the observation of an extended recovery phase is not uncommon in clinical trials of male fertility control based on steroid treatment. 1 5</em></p><p><em></em></p><p><em>Testicular size decreased by 50% under treatment, lagging behind the fall in sperm count. None of the subjects nor their sexual partners noticed the reduction in testicular size and none was informed about it to avoid psychological complications. This unrecognized effect cannot be considered an impeding side-effect.</em></p><p><em></em></p><p><em><strong>The erythropoietic effect seen at the end of the treatment phase was expected since androgens and especially their 5(3-metabolites stimulate erythropoiesis.16<em>,17</em></strong> 17-methyl-19- nortestosteronel8 and 17 -ethyl-19-nortestosteroneI9 9 are hepatotoxic, owing to 17-alkylation, but such effects have not been reported for 19-nortestosterone. The increase in aminotransferase levels may be of muscular rather than hepatic origin since the volunteers took heavy physical exercise during treatment and y-glutamyl transpeptidase, alkaline phosphatase, and bilirubin levels did not increase. The gain in body weight was apparently due to the muscular exercise rather than to an anabolic effect of 19-nortestosterone, since in normal men physical exercise increases muscle mass, regardless of whether an anabolic steroid has been administered.6,7</em></p><p><em></em></p><p><em>Testosterone or progestagens given as single entities fail to give effective and acceptable male fertility control;4,5,20 however, the combination of testosterone with progestagens or danazol appears more favorable.21,22 <strong>19-nortestosterone, an effective androgen-but approximately ten times more progestagenic than testosterone,14 has the qualities of -an androgen and a progestagen in a single molecule. </strong>Difficulties resulting from the different pharmacokinetics of two steroids given in combination and mutual interference are avoided when 19-nortestosterone is given alone. <strong>The effectiveness of 19-nortestosterone in suppressing spermatogenesis and simultaneously maintaining androgenic effects, as well as the long history of this drug uneventful in terms of toxic side-effects, render it an interesting candidate for further evaluation as an agent for male fertility control.</strong></em></p></blockquote><p></p>
[QUOTE="madman, post: 212320, member: 13851"] Might want to renege on that one! [I][B]*In all five volunteers levels of LH, FSH, and testosterone were reduced throughout treatment; [U]prolactin levels were unchanged [/U](fig 2).[/B][/I] [B]REVERSIBLE AZOOSPERMIA INDUCED BY THE ANABOLIC STEROID 19-NORTESTOSTERONE (1984) Subjects and Methods [/B] [I]Five healthy men aged 21-25 years consented to participate in the study after receiving extensive information about its aims and risks, in accordance with German drug regulations. None of the subjects had ever had any serious disease. All were active in sports and, aware that they were receiving an anabolic steroid, undertook heavy physical training during the treatment phase. The subjects had stable sexual relations during the investigation. [B]Physical examination, clinical chemistry, hematology, serum levels of the hormones luteinizing hormone (LH), follicle-stimulating hormone (FSH), [U]prolactin[/U], and testosterone, and semen analysis (sperm density, motility, morphology, and seminal fructose) were carried out twice during the control period (A and B): all results were normal. [/B]All subjects’ spermatozoa were functionally intact as assessed in the heterologous ovum penetration test.8,9[/I] [B][I]The subjects were given intramuscular. injections of 19- nortestosterone-hexoxyphenylpropionate (Pharmaleo, Ratingen, West Germany), for the [U]first 3 weeks 100 mg per week, then two 100 mg injections per week for a further 10 weeks[/U].[/I][/B][I] Throughout the study, the subjects were examined physically, and body weight and testicle and prostate size (as assessed by orchidometer and rectal palpation, respectively) were recorded.[B] Blood samples for endocrine measurements were taken at the end of every week before administration of the next dose, as well as 1, 4, 8, 16, and 20 weeks after the last injection.[/B] Clinical chemistry was repeated in weeks 2, 5, 8, and 11 of treatment and 1, 4, 8, 12, 16, and 20 weeks after treatment. Ejaculates were obtained during weeks 4, 7, 11, 12, and 13 of treatment. All subjects were followed up for 16 weeks. Seminal parameters had then returned to normal in two subjects. The remaining three were followed up to week 24. Semen evaluation was carried out according to World Health Organisation guidelines. 10 The subjects were requested to abstain from sexual activity for 48 h-7 days before the investigation (48 h in most cases). Testosterone was isolated from serum and separated from 19-nortestosterone by high-performance liquid chromatography, then measured by radioimmunoassay. 1,12 Reagents s provided by the WHO Matched Reagents Programme were used for measurement of serum LH by radioimmunoassay. FSH (IRE, Dusseldorf, West Germany) and prolactin (Serono, Freiburg, West Germany) were measured with commercially available radioimmunoassay kits. All results, expressed as mean±SEM, were analyzed by Student’s s paired t-test with the means of the two control values (A and B) as points of reference.[/I] [B]Results [I]None of the five volunteers complained of any discomfort during the study and there were no effects on general health, [U]no gynecomastia, and no acne[/U]. Prostate size did not change. [U]Libido and potency as reported in weekly interviews were unaltered[/U]. Testicular volumes fell from 39±3 ml to 21[B][I]±[/I][/B]3 ml at the end of treatment but returned to the original volume 16 weeks after treatment (fig 1).[/I][/B] Bodyweight (87.5[I]±[/I]0.9 kg at the beginning of the study) increased continuously to 94.0[I]±[/I]1.9 kg at the end of treatment; 16 weeks after treatment it had fallen to 92.0±2.6 kg. [I][B]In all five volunteers levels of LH, FSH, and testosterone were reduced throughout treatment; [U]prolactin levels were unchanged [/U](fig 2). [/B]FSH and LH remained below control levels until 8 and 16 weeks after treatment, respectively, and FSH was significantly above the control level at week 16. Serum testosterone concentrations returned to normal even more slowly, reaching control levels 6 months after the last injection. Azoospermia was first observed in one subject after 7 weeks’ treatment, and by week 13 all five men were azoospermic (fig 3). Azoospermia persisted for 4 to 14 weeks after treatment. However, the volunteer who first became azoospermic had 0 - 2 million sperm per ml in the first post-treatment week. Seminal measurements had returned to normal 8 weeks after treatment in one subject, 14 weeks in another, and 20 weeks in two. In the fifth subject, recovery was slow; 24 weeks after treatment the sperm concentration was still only 1 million/ml. (However, when subject 5 was investigated 30 weeks after treatment, all his seminal parameters had returned to normal: 33 million sperm/ml, 75% motile sperm, 51% normally formed sperm.) Whenever the heterologous ovum penetration test could be done the sperm were classified as functionally normal, except in subject 5 after 11 weeks’ treatment, when only 3% of the hamster eggs were penetrated (lower normal limit 10%). Ejaculate volumes and seminal fructose concentrations did not change significantly during the study (fig 1). Serum levels of alanine and aspartate aminotransferases and lactate dehydrogenase were significantly raised on one or two occasions, whereas y-glutamyl transpeptidase, alkaline phosphatase, and bilirubin did not rise above control levels (see table). Creatinine was raised on four occasions, but uric acid, cholesterol, and protein did not change significantly. [/I][B][I]The reticulocyte count slowly increased and reached peak values 4 weeks after the last injection: the highest erythrocyte count, hemoglobin, and hematocrit values occurred in weeks 8 and 12.[/I] Discussion[/B] [I]19-nortestosterone is one of the most widely used anabolic steroids, both in clinical medicine and in athletics. It is surprising that this[/I] well-known steroid, which has been used for more than 20 years without reports of serious toxic side-effects,[I] has these drastic effects on spermatogenesis. Possible explanations are that cachectic or convalescent patients receiving this steroid are not likely to be primarily interested in reproduction and that the testicular function of athletes taking the steroids secretly has never been thoroughly investigated. The dosage we tested is somewhat higher than that usually given to patients (50 mg/month to 100 mg/week) but is still lower than the quantities occasionally injected by athletes on the assumption that the drug will improve performance in competition. After 7-12 weeks’ treatment up to 4-14 weeks after the end of treatment the subjects could be considered infertile. The periods of azoospermia lasted for 5-20 weeks if the sperm concentration of 0 • 2 million/ml in one subject in the first post-treatment week is disregarded. The suppression of spermatogenesis is apparently caused by suppression of pituitary gonadotropins secretion. In contrast to Bijlsma et al,13 who described a fall in FSH and testosterone but not LH with 19-nortestosterone, we found simultaneous falls in LH, FSH, and testosterone. [B]Despite reduced testosterone levels none of our subjects reported a loss of libido or potency. This observation, together with the fact that prostate size, ejaculate volume, and seminal fructose levels did not change, indicates that 19-nortestosterone given in such doses has sufficiently high androgenic potency. In contrast, neither prostate hypertrophy nor acne, which would be expected with a similar testosterone dosage, developed. Therefore, the androgenic properties of 19-nortestosterone seem to be lower than those of testosterone. [U]19-nortestosterone itself does not bind to estrogen receptors14 and is poorly converted to estrogens[/U]. These facts may account for the lack of acne and gynecomastia in our subjects.[/B] The long-lasting suppression of serum LH, FSH, and testosterone after treatment indicates that 19-nortestosterone must remain in the body for some time. This finding may also explain why recovery of seminal parameters, at least in one subject, was very slow. However; the observation of an extended recovery phase is not uncommon in clinical trials of male fertility control based on steroid treatment. 1 5 Testicular size decreased by 50% under treatment, lagging behind the fall in sperm count. None of the subjects nor their sexual partners noticed the reduction in testicular size and none was informed about it to avoid psychological complications. This unrecognized effect cannot be considered an impeding side-effect. [B]The erythropoietic effect seen at the end of the treatment phase was expected since androgens and especially their 5(3-metabolites stimulate erythropoiesis.16[I],17[/I][/B] 17-methyl-19- nortestosteronel8 and 17 -ethyl-19-nortestosteroneI9 9 are hepatotoxic, owing to 17-alkylation, but such effects have not been reported for 19-nortestosterone. The increase in aminotransferase levels may be of muscular rather than hepatic origin since the volunteers took heavy physical exercise during treatment and y-glutamyl transpeptidase, alkaline phosphatase, and bilirubin levels did not increase. The gain in body weight was apparently due to the muscular exercise rather than to an anabolic effect of 19-nortestosterone, since in normal men physical exercise increases muscle mass, regardless of whether an anabolic steroid has been administered.6,7 Testosterone or progestagens given as single entities fail to give effective and acceptable male fertility control;4,5,20 however, the combination of testosterone with progestagens or danazol appears more favorable.21,22 [B]19-nortestosterone, an effective androgen-but approximately ten times more progestagenic than testosterone,14 has the qualities of -an androgen and a progestagen in a single molecule. [/B]Difficulties resulting from the different pharmacokinetics of two steroids given in combination and mutual interference are avoided when 19-nortestosterone is given alone. [B]The effectiveness of 19-nortestosterone in suppressing spermatogenesis and simultaneously maintaining androgenic effects, as well as the long history of this drug uneventful in terms of toxic side-effects, render it an interesting candidate for further evaluation as an agent for male fertility control.[/B][/I] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Testosterone plus Nandrolone = Estrogen overload?
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