Paradoxical release of LH under TRH dynamic test in patients suffering from "psychogenic" erective sexual impotency: lack of neuroradiological signs for hypophyseal lesions.

More than two thirds of the patients suffering from "psychogenic" erective sexual impotency display a paradoxical LH response to the injection of 200 micrograms of TRH. As it is known that similar responses exist in patients with gonadotropic cell adenomas, we undertook a tomographic examination of the sella turcica in 8 such patients. In none of the patients did the results favour the existence of a microadenoma. Though the hypothesis of an infra-radiological microadenoma cannot be excluded, it is highly plausible that the origin of the paradoxical response observed is a functional impairment of the hypothalamo-hypophyso-gonadal regulation.