Androgens and oestrogens before and following oral testosterone administration in male patients with and without alcoholic cirrhosis

Abstract

Compared with controls (N = 9), alcoholic cirrhotic men (N = 14) showed: significantly (P < 0.05) higher serum concentrations of sexual hormone binding globulin (SHBG), androstenedione, oestrone, oestradiol, non-protein bound oestradiol, and non\x=req-\ SHBG bound oestradiol; significantly (P < 0.05) lower concentrations of albumin and non-SHBG bound testosterone; no significant differences regarding concentrations of testosterone, dihydrotestosterone, non-protein bound testosterone, oestrone sulphate, and SHBG bound oestradiol. Following oral administration of 400 mg of micronized testosterone, serum concentrations of testosterone, dihydrotestosterone, androstenedione, and oestrone increased significantly (P < 0.05) in both groups, cirrhotic patients reaching significantly (P < 0.01) higher concentrations than controls. Further, in the cirrhotic group, the serum concentrations of oestrone sulphate, oestradiol, non-protein bound oestradiol, and non-SHBG bound oestradiol, and the urinary excretion of oestrogen increased significantly (P <0.05). In conclusion, peroral testosterone administration decreases the serum oestradiol/testosterone ratio in patients with normal livers as well as in patients with alcoholic cirrhosis, but the latter group obtains significantly higher oestrogen concentrations.

The effect of oral testosterone on serum TBG levels in alcoholic cirrhotic men

“…The present study shows that it is possible to influence the level of TBG with oral testosterone only in patients with well-preserved liver function (Child-Turcotte's Group A). Serum concentrations of androgens after an oral dose of testosterone reach significantly higher values in cirrhotic patients than in normal males (26,27). and the small changes in TBG levels found in the present study are in discrepancy with the substantial increase in serum testosterone concentrations.…”

Effect of oral testosterone treatment on serum concentrations of sex steroids, gonadotrophins and prolactin in alcoholic cirrhotic men

“…'~ The variation in serum testosterone concentrations during oral testosterone treatment may be explained by variation in the time interval between last tablet intake and blood ampl ling'^,^^-'^ and/or by the severity of liver cirrhosis.' After a single oral administration of 400 mg micronized testosterone to alcoholic cirrhotic men, maximal serum concentrations of testosterone are reached in about 2 h and serum testosterone concentrations stay significantly raised for 24 h. 23 The serum half-life of testosterone in normal men has been reported to be from 10.7 to 7.0 h after a similiar dose of oral micronized test~sterone. '~ The cirrhotic patients had significantly increased median serum concentrations of oestrone at entry whereas other median serum oestrogen concentrations did not dlffer significantly from control concentrations.…”

Hormonal Status of Postmenopausal Women With Alcohol–Induced Cirrhosis: Further Findings and A Review of the Literature

“…Are women with alcohol-induced liver disease hyperfeminized, hypofeminized or perhaps even masculinized? In the face of gynecomastia, spider angiomata, palmer erythema and a female escutcheon, estrogen levels have been measured in several cohorts of cirrhotic alcoholic men (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17); among such men, estradiol has been found to be statistically elevated in 9 of 16 studies (1-16), and estrone has been found to be increased in all 9 studies in which it was measured (5,6,9,10,(12)(13)(14)16,17). Studies of the hormonal status of women with alcohol-induced liver disease are at best difficult to perform in women during the reproductive years because of the cyclic nature of hormone levels.…”