Cyproterone acetate (100-150 mg daily) was administered to 8 male patients with excessive libido. Within 3 months a significant fall (P < 0.02) in plasma testosterone was demonstrated. The plasma luteinising hormone (LH) and follicle stimulating hormone (FSH) responses to gonadotrophin releasing hormone (LH/FSH-RH) were also significantly impaired (P < 0.05). A direct correlation between the resting plasma testosterone level and the LH response to LH/FSH-RH was demonstrated (r = 0.743). It is concluded that the fall in plasma testosterone levels in patients receiving cyproterone acetate may be attributed to suppression of LH release, rather than an antiandrogen effect on the testis or hypothalamus.Cyproterone has been shown to have an antiandrogenic action in laboratoryanimals and inhibits the development of male sex organs (Hamada et al. 1963). The acetate derivative produces a fall in plasma testosterone levels in man (Murray et al. 1973) and has been used in the treatment of hypersexuality (Laschet 8c Laschet 1967), sexual precocity (Rager et al. 1973) and hirsutism (Hammerstein 8c Cupceancu 1969;Ismail et al. 1974).The mode of action of cyproterone acetate is imperfectly understood, al¬ though it is thought to have both antiandrogenic and progestogenic properties (Brotherton 1974). A fall in urine FSH excretion has been demonstrated (Vosbeck 8c Keller 1971) but not confirmed (Brotherton 1974). Resting plasma
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