中等剂量醋酸环丙孕酮（CPA）：对男性激素分泌和精子发生的影响。

Medium dose cyproterone acetate (CPA): effects on hormone secretion and on spermatogenesis in men.

作者信息

Moltz L, Römmler A, Post K, Schwartz U, Hammerstein J

出版信息

Contraception. 1980 Apr;21(4):393-413. doi: 10.1016/s0010-7824(80)80017-5.

Abstract

Medium dose cyproterone acetate (CPA; 10 mg daily p.o.) was administered to 10 fertile men for 12 weeks. Hormonal measurements and semen analyses were performed before, during (4th and 12th week) and after CPA treatment. At the hypothalamo-pituitary level CPA significantly reduced the hypophyseal storage and synthesis capacity for gonadotropins. Basal LH and FSH concentrations were suppressed by 30% and 40%, respectively; while basal prolactin was elevated by 75%. The episodic fluctuations of peripheral gonadotropins remained unaffected. At the testicular level CPA significantly decreased basal testosterone and dihydrotestosterone concentrations by 70% and 50%, respectively. The pulsatile pattern of androgen secretion was abolished. CPA also inhibited spermatogenesis and motility. No serious clinical side effects were observed. All changes appeared to be completely reversible. It is concluded that medium dose CPA induces progestational/anti-gonadotropic effects at the hypothalamo-pituitary level in addition to its antiandrogenic action at the testicular level.

摘要

给10名有生育能力的男性服用中等剂量的醋酸环丙孕酮（CPA；每日口服10毫克），持续12周。在CPA治疗前、治疗期间（第4周和第12周）以及治疗后进行激素测量和精液分析。在丘脑下部-垂体水平，CPA显著降低了垂体对促性腺激素的储存和合成能力。基础促黄体生成素（LH）和促卵泡生成素（FSH）浓度分别被抑制了30%和40%；而基础催乳素升高了75%。外周促性腺激素的间歇性波动未受影响。在睾丸水平，CPA使基础睾酮和双氢睾酮浓度分别显著降低了70%和50%。雄激素分泌的脉冲模式被消除。CPA还抑制精子发生和活力。未观察到严重的临床副作用。所有变化似乎完全可逆。结论是，中等剂量的CPA除了在睾丸水平具有抗雄激素作用外，还在丘脑下部-垂体水平诱导孕激素/抗促性腺激素作用。