Effects of ethinyl estradiol on semen quality
and various hormonal parameters in a eugonadal male.
Lubbert H, Leo-Rossberg I, Hammerstein J.
Hospital for Women, Department of
Gynaecological Endocrinology and Reproductive Medicine, Free University of
Berlin, Germany.
Abstract [Full Text] [PDF]
Abstract
OBJECTIVE: To determine the influence of estrogens on male fertility. DESIGN: A
36-year-old eugonadal male was subjected to two different regimens of treatment
with ethinyl estradiol (EE2). Sperm quality, immunoreactive luteinizing hormone
(LH) and follicle-stimulating Hormone (FSH), testosterone (T), estrone (E1),
estradiol (E2), dehydroepiandrosterone sulfate (DHEAS), prolactin (PRL) and sex
hormone-binding globulin were determined at intervals of 2 weeks for 315 days.
SETTING: A gender dysphoria clinic.
PATIENT: A transsexual male nurse. MAIN OUTCOME
MEASURES: It was hypothesized (and confirmed) that by comparing the effects of
increasing and constant dose of EE2 on fertility parameters, differences in
estrogen-sensitivity would show more clearly. Furthermore, this procedure served
to find the minimal dose of EE2 for complete testicular suppression. RESULTS:
Low doses of EE2 (20 micrograms/d) had no negative effect on sperm motility and
density for a period of approximately 4 weeks, whereas high doses (60
micrograms/d) reduced motility already after a few days and led to a pronounced
decrease in sperm density after 2 weeks. After discontinuation of therapy,
motility normalized faster than sperm density. Under increasing doses of EE2
there was a constant decrease of FSH that occurred several weeks earlier than
that of LH. Under constant dose of EE2 (60 micrograms/d) the decrease of LH was
delayed (with respect to FSH) by only a few days. The decrease in T showed a
stronger correlation with that of FSH than with that of LH. Volume and fructose
content of the seminal fluid correlated with the decrease in T. Rebound effects
were observed for FSH, LH, T, and fructose during the therapy-free interval.
Ethinyl estradiol therapy had no influence on the serum concentrations of E1,
E2, and PRL. Estrone was the dominant estrogen before and after therapy with
EE2. Adrenal gland activity was markedly suppressed by EE2, as reflected by the
decrease in DHEAS.
CONCLUSION: The suppressive effect of EE2 on
FSH and sperm motility was more pronounced and consistent than on LH and sperm
density. The T decrease appears to be mainly caused by a direct effect of EE2 on
the testes.
Publication Types:
Publication Types:
MeSH Terms:
- Adult
- Dehydroepiandrosterone/analogs
& derivatives
- Dehydroepiandrosterone/blood
- Dehydroepiandrosterone
Sulfate
- Estradiol/blood
- Estrone/blood
- Ethinyl
Estradiol/administration & dosage
- Ethinyl
Estradiol/pharmacology*
- Follicle Stimulating Hormone/blood
- Fructose/metabolism
- Humans
- Luteinizing
Hormone/blood
- Male
- Prolactin/blood
- Semen/drug effects
- Semen/physiology*
- Sex Hormone-Binding Globulin/metabolism
- Sperm Count
- Sperm Motility/drug effects
- Spermatozoa/drug effects
- Spermatozoa/physiology*
- Testosterone/blood
- Transsexualism*
Substances:
- Sex Hormone-Binding Globulin
- Fructose
- Estradiol
- Estrone
- Dehydroepiandrosterone
- Ethinyl
Estradiol
- Testosterone
- Dehydroepiandrosterone
Sulfate
- Prolactin
- Luteinizing
Hormone
- Follicle Stimulating Hormone
Citation:
Lubbert H, Leo-Rossberg I, Hammerstein J.
