Comparison of short and long-term treatment with synthetic LH-releasing hormone and clomiphene citrate in male hypothalamic hypogonadism.

The effects of short and long-term treatment with clomiphene citrate and with synthetic LH-releasing hormone (LHRH) on gonadotropin release were studied in 5 male patients with hypothalamic hypogonadism. Neither short-term treatment with clomiphene citrate (50 mg or 200 mg daily for 4 days) nor long-term treatment (25 mg or 100 mg for 30-62 days) was effective in increasing serum LH and FSH in any patients. On the other hand, 5 cases showed slight or no rise in LH after administration of a single dose of 100 mug LH-releasing hormone (LHRH) and higher rises after administration of 400 mug. Four cases who were given 200 mug LHRH daily for 3 weeks showed an increasing response of serum LH and reached maximal LH levels at 2 weeks, followed by no further increase. In two of the four cases serum LH level reached normal adult male ranges. There was no increase of serum testosterone during LHRH treatment. These results suggest that long-term treatment with synthetic LHRH may be effective for gonadotropin restoration in some patients with hypothalamic hypogonadism in which long-term treatment of clomiphene citrate was shown to be ineffective.