[Effects of long-term use of mesterolone on different urine metabolites in andrological patients (author's transl)].

We studied whether long-term use of mesterolone (12 weeks and longer) changed the pattern of steroid metabolites in urine from male subjects. We noticed an increase in dehydroepiandrosterone (DHEA) levels from 211-4 +/- 130.5 ug/die to 9943.8 +/- 6564.7 ug/die in the urine of all subjects tested. This increase was significant. After mesterolone administration was discontinued, DHEA levels decreased to their initial value. DHEA levels showed the smallest increase in those subjects having high plasma FSH levels. Perhaps the delta 4 pathway of testosterone synthesis may be preferred in these three subjects. We suppose that mesterolone has a blocking effect on the delta 5 pathway of testosterone synthesis. DHEA from the DHEA-pool can be used for testosterone synthesis and mesterolone seems to block some enzymes in the synthetic pathway. We were not able to detect a decrease in plasma testosterone levels during mesterolone use because of technical problems. Moreover, our patients told us that they felt ill after discontinuing mesterolone use; it may be possible that there is a psychotropic DHEA-effect during mesterolone use.