Clomiphene citrate treatment for late onset hypogonadism: rise and fall

ABSTRACT Objective: Previous series have demonstrated that Clomiphene Citrate (CC) is an effective treatment to increase Total Testosterone (TT) in Late Onset Hypogonadism (LOH) patients. However, what happens to TT levels after ending CC treatment is still debatable. The objective of this study is to evaluate TT levels 3 months after the discontinuation of CC in patients with LOH who were previously successfully treated with the same drug. Materials and Methods: Twenty-seven patients with LOH that were successfully treated (achieved TT levels >11nmol/l) with CC 50mgs daily for 50 days were prospectively recruited in our Andrological outpatient clinic. CC was then stopped for 3 months and TT levels were measured at the end of this period. Results: Mean TT level before discontinuation of CC was 22.7±8.1nmol/L (mean±SD). Three months after discontinuation, mean TT level significantly decreased in all patients, 10.2±3.9nmol/l (p<0.01). Twenty-one patients (78%) decreased TT levels under 11nmol/L. Six patients (22%) had TT levels that remained within the normal recommended range (≥11nmol/l). No statistical significant differences were observed between both groups. Conclusion: In the short term LOH does not seem to be a reversible condition in most patients after CC treatment. More studies with longer follow-up are needed to evaluate the kinetics of TT in LOH.

Relación entre índice de masa corporal, cáncer de próstata, antígeno prostático específico y score de Gleason / Is body mass index related to prostate cancer, PSA and Gleason score?

Objetivo: Evaluar la relación entre índice de masa corporal (IMC), riesgo de cáncer de próstata, antígeno prostático específico (APE) y score de Gleason en 505 pacientes sometidos a biopsia prostática. Pacientes y Métodos: Se realizó un estudio caso control evaluando la relación entre IMC y cáncer de próstata. En los pacientes con cáncer de próstata se evaluó la relación entre IMC (<25, <25<30, <30), APE y score de Gleason. Resultados: Adenocarcinoma de próstata fue diagnosticado en 201 pacientes. Al estratificar el IMC (<25, <25<30, <30) de los pacientes y relacionarlo con la presencia o ausencia de cáncer no se encontró asociación estadísticamente significativa entre los grupos. Se encontró un mayor riesgo de cáncer de próstata en los pacientes de mayor estatura. En los pacientes con cáncer no se encontró asociación estadísticamente significativa entre IMC, APE y score de Gleason. Conclusión: No se encontró asociación entre obesidad y cáncer de próstata. Existe un mayor riesgo de cáncer de próstata a mayor estatura. En los pacientes con diagnóstico de cáncer de próstata no se encontró asociación entre obesidad, APE y score de Gleason.

Objetive: To evaluate the relationship between Body Mass Index (BMI), prostate cancer risk, prostate specific antigen (PSA) and Gleason score in 505 patients who underwent transrectal prostatic biopsy. Patients and Methods: We designed a Case-Control study to evaluate the relationship between BMIand the presence of prostate cancer. In the patients with the diagnosis of prostate cancer we evaluated the relationship between BMI (<25, <25<30, <30), PSA levels and Gleason score. Results: Prostate cancer was diagnosed in 201 patients. BMI (<25, <25<30, <30) was not related to the presence of prostate cancer. Height was associated with an increased risk of prostate cancer. Noassociation was found between BMI, PSA levels and Gleason score in patients with prostate cancer. Conclusions: The results of this study support the hypothesis that BMI is not associated with prostate cancer risk in Chilean population. Height is associated with an increased risk of prostate cancer. Inpatients with prostate cancer no association was found between BMI, PSA levels and Gleason score.