Acceleration of puberty in boys with delayed puberty by clomiphene citrate. A clinical and laboratory study

Abstract

Clomiphene citrate was administered at a dose of 50 mg/day for 3 months to 29 boys with delayed puberty, 15 in a stage of early puberty (group 1) and 14 in stages of mid puberty (group 2). In both groups a significant acceleration in the advancement of pubertal signs was noted in the 6-month period following initiation of therapy as compared to a non-treated control group. A significant rise in the mean (\m=+-\SD) basal plasma LH levels, from 1.0 \m=+-\0.4 to 2.7 \ m=+-\2.2 mU/ml in group 1 (P< 0.05) and from 1.0 \ m=+-\0.6 to 2.2 \m=+-\1.7 mU/ml in group 2 (P < 0.05) was observed following the treatment period with clomiphene. Concomitantly there was a rise of the mean basal plasma FSH level from 1.1 \m=+-\0.4 to 2.0 \m=+-\1.5 mU/ml in group I (P \ m=+-\0.05) and from 1.9 \ m=+-\ 1.6 to 3.4 \m=+-\3.0 mU/ml in group 2 (P <0.02). The mean LH peak response to an iv bolus of LRH (50 \g=m\g/m2 iv) rose from 8.3 \m=+-\4.2 to 13.0 \m=+-\5.3 mU/ml in group 1 (P < 0.05) and from 9.2 \ m=+-\5.8 to 12.6 \ m=+-\6.8 mU/ml in group 2 (NS). The mean peak plasma FSH response to LRH rose from 2.0 \ m=+-\0.6 to 5.9 \ m=+-\4.2 mU/ml in group 1 (P < 0.05) and from 4.3 \ m=+-\ 4.0 to 7.0 \ m=+-\ 6.8 mU/ml in group 2 (NS).Clomiphene therapy caused a rise of the basal plasma testosterone level from 68 \ m=+-\53 to 313 \m=+-\270 ng/100 ml in group 1 (P <0.01) and from 103 \ m=+-\67 to 392 \ m=+-\248 ng/100 ml in group 2 (P< 0.01). The plasma testosterone response to one hCG stimulation (5000 U im), tested in 4 boys immediately before and after the 3-month period of clomiphene administration revealed an increase in both the basal and the peak testosterone levels (P < 0.05 and P< 0.001, respectively). A standard clomiphene test consisting of the administration of 100\p=n-\200 mg/day clomiphene citrate for 8 days was performed in 8 boys before initiation of clomiphene treatment for the 3-month period. In 4, including 2 boys in an early stage of puberty, there was a suppression of the basal level of gonadotrophins and their response to synthetic LRH. The other 4 boys, all of them in stages of mid-puberty, showed an increase in the basal and peak plasma gonadotrophin levels following LRH stimulation. In all 8 boys there was a significant rise of the basal plasma testosterone level. Despite the varying response to the short clomiphene test in these 8 boys, all gave a good response to the prolonged administration of clomiphene citrate. It was concluded that treatment with small doses of clomiphene citrate for a period of 3 months induces an acceleration of puberty in boys with delayed or slowlyprogressing puberty, once the stage of initiation of puberty has been passed.Delayed puberty in boys is one of the frequent causes for referral to our Insitute, and among the various aetiologies of delayed puberty in boys 'con¬ stitutional' delayed puberty is the most common (Root 1973). The introduction of sensitive radio¬ immunoassay (RIA) methods for the measurement of plasma gonadotrophins and testosterone levels and the availability of synthetic LR...

Effect of Clomiphene Citrate on Gonadotropin Hormones Fsh, Lh and Testosterone Levels in Mice Offspring

“…[17] Although, as acceleration of puberty in 29 boys with delayed puberty were treated with CC 50 mg/day for 3 months, CC therapy caused a rise in T level in the treatment groups. [18] Another increased of T level were found as a result of oral administered of CC 25mg/day for male testosterone deficiency. [19] On other hand in women CC treatment showed a reverse result to the present study as where confirmed reported increases in FSH and LH levels several days after CC administration.…”