The acute effect of sleep deprivation on the pituitary-testis axis was evaluated in 13 healthy men. To study such association, the circulating levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), Androstenedione (A), Testosterone (T), Dihydrotestosterone (DHT) and Estradiol (E2) were measured along with Cortisol (C) before and after sleep deprivation. Morning (8:OO AM) venous blood samples were obtained prior and after a continuous restless period of 24 hr and the values were analyzed by the paired Student's r test. There was a significant and parallel decrease of each androgen and E2 but not of FSH, LH.PRL, or C, associated with the acute sleep deprivation.

The principal technique of hormonal methods of contraception, based on original studies by Pincus et al. (1958), has relied on the joint action of an oestrogen (mestranol) and a progestogen (norethynodrel) given cyclically for 20 days monthly. Combinations of other progestogens with either mestranol or ethinyloestradiol have also been studied. The biological and clinical basis of the antifertility effects of these agents were reviewed by Diczfalusy (1965) and by Rudel and Kincl (1966). The contraceptive mechanisms were described as (1) inhibition of ovulation, by both the oestrogen and the progestogen; and, fTom the anti-oestrogenic action of the progestogen, (2) a suppressed endometrium unfavourable to nidation, with (3) a cervical mucus hostile to spermatozoal motility. Definitive data on human tubal physiology relating to these agents have not been reported. Mestranol or ethinyloestradiol, given early and with regularity before ovulation, consistently inhibits its occurrence (Rudel and Martinez-Manautou, 1964; MartinezManautou and Rudel, 1966). Similar observations were made for ethinyloestradiol by Greenblatt et al. (1954). Thus, with the anti-ovulatory role of oestrogen and the anti-oestrogenic effects of progestogen defined, the concept of sequential therapy evolved-that is, early oestrogen for inhibition of ovulation, and later oestrogen plus progestogen to promote maturation of the endometrium with regular withdrawal bleeding. Oestrogen and progestogen, used concomitantly or sequentially, suppress the hypothalamic-pituitary-gonadal cycle, thus preventing ovulation and the normal endogenous regulation of the uterine bleeding cycle.On evaluating the contraceptive potential of the progestogen chlormadinone acetate in a daily dosage range of 0.5 mg. to 4 mg., a sensitivity differential was found between dosage and the development and degree of (1) inhibition of cervical mucus fluidity, (2) suppression of the endometrium, and (3) inhibition of ovulation (Rudel, 1964 ;Rudel et al., 1965Rudel et al., , 1967 MartinezManautou and Rudel, 1967). Within this range the highest doses produced all three effects, whereas on reducing the dosage to 0.5 mg. only inhibition of the cervical mucus was uniformly maintained; there was some endometrial suppression and, to a lesser degree, inhibition of ovulation. Though, originally, small numbers of women were studied, no pregnancies were seen with chlormadinone acetate 0.5 mg. daily. This suggested a method in which progestogen given uninterruptedly in small daily doses produces contraception without inhibiting ovulation, and if the pituitary-gonadal axis is not interrupted normal menstruation would occur.Prompted by these observations, Martinez-Manautou et al. (1966) carried out a clinical study to define the contraceptive effectiveness of a continuous daily dose of chlormadinone acetate 0.5 mg. Three hundred and twenty women were observed for 1,214 cycles, and two pregnancies were reportedone, as a failure of the method. Approximately 60% of the group had cycles ranging betw...

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Three 46,XY phenotypically male, azoospermic brothers out of thirteen sibs from a consanguineous marriage were studied and found to have a unique pattern of testicular histology with arrest of spermatogenesis at the pachytene stage of primary spermatocytes. Endocrinological evaluation showed elevated plasma luteinizing(LH) and normal to elevated follicle-stimulating (FSH) hormones, positive gonadotropin pituitary response to luteinizing hormone-releasing hormone, depletion of LH and FSH levels by exogenous testosterone (T) administration, normal levels of T and dihydrotestosterone hormones, and elevation of T after stimulation with human chorionic gonadotropin hormone. Electrophoretic assay of lactic dehydrogenase isozymes did not reveal band C4 in semen or testicular tissue. These traits seem to constitute a hitherto undescribed form of infertility in which spermatogenesis arrest at the first spermatocyte level is the main feature. The parental consanguinity suggests autosomal recessive inheritance.

The effect of the neuro-spinal cord injury upon testicular physiology was evaluated in six adult paraplegic (PPG) men by measuring the circulating levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), androstenedione, testosterone, and dihydrotestosterone every 4 hr throughout a 24-hr period. Three PPG men were studied within the first 3 months (acute period) and the other three patients 39-79 months (stabilized period) after trauma. Hormonal values were compared with eight age-matched normal adult males. Plasma FSH and LH were constantly above normal concentrations regardless of the sampling time and period of observation, whereas prolactin was higher than normal only during the first two months after trauma, returning to normal afterwards. Plasma androgens were consistently below normal during the first 3 months after injury, and returned toward normal thereafter. There may be a direct relationship between the time elapsed after the spinal cord injury and the plasma androgens concentrations. A possible role of PRL in testicular steroidogenesis is suggested.

Plasma concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), 17 alphahydroxyprogesterone (17\g=a\-OPH),androstenedione (\ g=D\ 4) and testosterone (T) were measured in 543 healthy boys aged 6.0 to 15.9 years (with weight and height between the 3rd and 97th percentile for Mexican standards) as a function of chronologic age (CA), weight, height, surface area (SA) and calculated lean body mass (LBM) and total body fat (TBF).The earliest hormonal event was a clear rise in plasma 17\g=a\-OHP, either prior or simultaneously to at steady increase in plasma FSH, far ahead of any sign of puberty. These changes were closely followed by a continuous rise in plasma \ g=D\ 4. Thereafter, there was a prolonged period of low but progressively increasing plasma FSH levels in the face of constantly low LH levels. However, a brisk rise in plasma LH and FSH occurred at a mean weight of 35.4 kg, at a height of 144.5 cm and when LBM was 32.0 kg. Simultaneously, plasma 17\g=a\-OHP began to fall, \ g=D\ 4 reached a plateau and soon after, a marked rise in plasma T was documented. When plasma LH and FSH concentrations were plotted against CA, weight, height, SA and LBM a significant quadratic equation was disclosed in each case. Both gonadotrophins did not correlate with TBF. Multiple variance analysis demonstrated that LBM and SA had the most marked effect on LH, while LBM was the most important variable affecting plasma FSH concentrations. The present data suggest the association between a "critical level" of body composition and the major hormonal events in boys, regardless of a causeeffect relationship. A critical level of LBM (20\p=n-\23 kg) and not of TBF was attained at time of the initial hormonal changes, as well as at the time of the major changes in plasma gonadotrophins (32\p=n-\35 kg).

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Abstract. An 18 year-old 46,XY female-reared patient with incomplete male pseudohermaphroditism type 2 (5α-reductase deficiency) was studied. She had a male habitus, Wolffian ducts derivatives, normal testes and small phallus; there were no Mullerian duct derivatives nor gynaecomastia. Clinical and genetic data were typical of the diagnosis which was corroborated by endocrinological studies. Normal LH, FSH, testosterone (T) and oestradiol and decreased dihydrotestosterone (DHT) plasma levels before and after hCG administration were found; the T:DHT ratio was highly increased. The histopathological studies of a testis biopsy showed a normal adult male pattern, and the meiotic chromosomes were interpreted as normal. After assessment of her psychosexual orientation, successful surgical and medical therapy to maintain and improve her femaleness was effectuated. The post-pubertal gender role switch commonly observed in these female-reared patients is discussed.