Skip to main content
NCBI home page
Gut logoLink to Gut
. 1983 Feb;24(2):127–135. doi: 10.1136/gut.24.2.127

Male gonadal function in coeliac disease: 2. Sex hormones.

M J Farthing, L H Rees, C R Edwards, A M Dawson
PMCID: PMC1420172  PMID: 6682819

Abstract

Hypogonadism, infertility, and sexual dysfunction occur in some men with coeliac disease. We have measured plasma testosterone, dihydrotestosterone, sex-hormone binding globulin, oestradiol, and serum luteinising hormone in 41 men with coeliac disease and have related these findings to jejunal morphology, fertility, semen quality, and sexual function. To determine the specificity of these observations in coeliacs we also studied 19 nutritionally-matched men with Crohn's disease, and men with chronic ill-health due to rheumatoid arthritis and Hodgkin's disease. The most striking endocrine findings in untreated coeliacs were increased plasma testosterone and free testosterone index, reduced dihydrotestosterone (testosterone's potent peripheral metabolite), and raised serum luteinising hormone, a pattern of abnormalities indicative of androgen resistance. As jejunal morphology improved hormone levels appeared to return to normal. This specific combination of abnormalities was not present in any of the disease control groups and, to our knowledge, androgen resistance has not been described previously in any other non-endocrine disorder. Plasma oestradiol concentration was modestly raised in 10% of coeliacs and 11% of patients with Crohn's disease. Unlike plasma androgens and serum luteinising hormone in coeliacs, plasma oestradiol was not clearly related to jejunal morphology. Androgen resistance and associated hypothalamic-pituitary dysfunction appear to be relatively specific to coeliac disease and cannot be explained merely in terms of malnutrition or chronic ill-health. In addition, our findings suggest that this endocrine disturbance may be related to sexual dysfunction in coeliac disease but its relationship to disordered spermatogenesis in this condition has not been clearly established.

Full text

PDF
127

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abraham G. E., Tulchinsky D., Korenman S. G. Chromatographic purification of estradiol-17 for use in radio-ligand assay. Biochem Med. 1970 Apr;3(5):365–368. doi: 10.1016/0006-2944(70)90002-5. [DOI] [PubMed] [Google Scholar]
  2. Aiman J., Griffin J. E., Gazak J. M., Wilson J. D., MacDonald P. C. Androgen insensitivity as a cause of infertility in otherwise normal men. N Engl J Med. 1979 Feb 1;300(5):223–227. doi: 10.1056/NEJM197902013000503. [DOI] [PubMed] [Google Scholar]
  3. Anderson D. C. Sex-hormone-binding globulin. Clin Endocrinol (Oxf) 1974 Jan;3(1):69–96. doi: 10.1111/j.1365-2265.1974.tb03298.x. [DOI] [PubMed] [Google Scholar]
  4. Baronos S., Mann T., Rowson L. E., Skinner J. D. The effect of nutrition and androgens on the composition of bovine blood plasma and seminal plasma at puberty. Br J Nutr. 1969 Mar;23(1):191–201. doi: 10.1079/bjn19690022. [DOI] [PubMed] [Google Scholar]
  5. Barry R. E., Baker P., Read A. E. Coeliac disease. The clinical presentation. Clin Gastroenterol. 1974 Jan;3(1):55–69. [PubMed] [Google Scholar]
  6. Chen J. C., Vidt D. G., Zorn E. M., Hallberg M. C., Wieland R. G. Pituitary-leydig cell function in uremic males. J Clin Endocrinol Metab. 1970 Jul;31(1):14–17. doi: 10.1210/jcem-31-1-14. [DOI] [PubMed] [Google Scholar]
  7. Day G., Evans K., Wharton B. Abnormalities of insulin and growth hormone secreton in children with coeliac disease. Arch Dis Child. 1973 Jan;48(1):41–46. doi: 10.1136/adc.48.1.41. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Dohan F. C. Coeliac disease and schizophrenia. Lancet. 1970 Apr 25;1(7652):897–898. doi: 10.1016/s0140-6736(70)91729-0. [DOI] [PubMed] [Google Scholar]
  9. Farthing M. J., Rees L. H., Edwards C. R., Byfield P. G., Himsworth R. L., Dawson A. M. Thyroid hormones and the regulation of thyroid function in men with coeliac disease. Clin Endocrinol (Oxf) 1982 Jun;16(6):525–535. doi: 10.1111/j.1365-2265.1982.tb03169.x. [DOI] [PubMed] [Google Scholar]
  10. Farthing M. J., Vinson G. P., Edwards C. R., Dawson A. M. Testosterone metabolism by the rat gastrointestinal tract, in vitro and in vivo. Gut. 1982 Mar;23(3):226–234. doi: 10.1136/gut.23.3.226. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Golder M. P., Phillips M. E., Fahmy D. R., Preece P. E., Jones V., Henk J. M., Griffiths K. Plasma hormones in patients with advanced breast cancer treated with tamoxifen. Eur J Cancer. 1976 Sep;12(9):719–723. doi: 10.1016/0014-2964(76)90022-0. [DOI] [PubMed] [Google Scholar]
  12. Green J. R., Goble H. L., Edwards C. R., Dawson A. M. Reversible insensitivity to androgens in men with untreated gluten enteropathy. Lancet. 1977 Feb 5;1(8006):280–282. doi: 10.1016/s0140-6736(77)91825-6. [DOI] [PubMed] [Google Scholar]
  13. HULTGREN H. N. Clinical and laboratory observations in severe starvation. Stanford Med Bull. 1951 Aug;9(3):175–191. [PubMed] [Google Scholar]
  14. Hemmings W. A. The entry into the brain of large molecules derived from dietary protein. Proc R Soc Lond B Biol Sci. 1978 Feb 23;200(1139):175–192. doi: 10.1098/rspb.1978.0014. [DOI] [PubMed] [Google Scholar]
  15. Howland B. E. The influence of feed restriction and subsequent re-feeding on gonadotrophin secretion and serum testosterone levels in male rats. J Reprod Fertil. 1975 Sep;44(3):429–436. doi: 10.1530/jrf.0.0440429. [DOI] [PubMed] [Google Scholar]
  16. Imperato-McGinley J., Guerrero L., Gautier T., Peterson R. E. Steroid 5alpha-reductase deficiency in man: an inherited form of male pseudohermaphroditism. Science. 1974 Dec 27;186(4170):1213–1215. doi: 10.1126/science.186.4170.1213. [DOI] [PubMed] [Google Scholar]
  17. Imperato-McGinley J., Peterson R. E., Gautier T., Sturla E. Male pseudohermaphroditism secondary to 5 alpha-reductase deficiency--a model for the role of androgens in both the development of the male phenotype and the evolution of a male gender identity. J Steroid Biochem. 1979 Jul;11(1B):637–645. doi: 10.1016/0022-4731(79)90093-1. [DOI] [PubMed] [Google Scholar]
  18. Ito T., Horton R. The source of plasma dihydrotestosterone in man. J Clin Invest. 1971 Aug;50(8):1621–1627. doi: 10.1172/JCI106650. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Mahoudeau J. A., Bardin C. W., Lipsett M. B. The metabolic clearance rate and origin of plasma dihydrotestosterone in man and its conversion to the 5-alpha-androstanediols. J Clin Invest. 1971 Jun;50(6):1338–1344. doi: 10.1172/JCI106613. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Pazzagli M., Giusti G., Forti G., Fiorelli G., Menchini-Fabris F., Scarselli G. F., Guazzelli R., Conti C., Borrelli D., Cicchi P. Seminal plasma levels of testosterone and 5 alpha-dihydrotestosterone in azoospermic patients. Clin Endocrinol (Oxf) 1979 Jul;11(1):11–14. doi: 10.1111/j.1365-2265.1979.tb03042.x. [DOI] [PubMed] [Google Scholar]
  21. Pearlman W. H., Crépy O., Murphy M. Testosterone-binding levels in the serum of women during the normal menstrual cycle, pregnancy, and the post-partum period. J Clin Endocrinol Metab. 1967 Jul;27(7):1012–1018. doi: 10.1210/jcem-27-7-1012. [DOI] [PubMed] [Google Scholar]
  22. Ramadas S. R., Chaudhuri A. P., Surya Prakash G. K. Heterocyclic steroids. Part-V. Studies on the total synthesis of racemic 3-methoxy-7-oxaestra-1,3,5(10),8-tetraen-17(e)-ol. Steroids. 1976 Aug;28(2):197–209. doi: 10.1016/0039-128x(76)90109-4. [DOI] [PubMed] [Google Scholar]
  23. Strober W. Gluten-sensitive enteropathy. Clin Gastroenterol. 1976 May;5(2):429–452. [PubMed] [Google Scholar]
  24. Stubbs W. A., Delitala G., Jones A., Jeffcoate W. J., Edwards C. R., Ratter S. J., Besser G. M., Bloom S. R., Alberti K. G. Hormonal and metabolic responses to an enkephalin analogue in normal man. Lancet. 1978 Dec 9;2(8102):1225–1227. doi: 10.1016/s0140-6736(78)92100-1. [DOI] [PubMed] [Google Scholar]
  25. Tamm J., Beischer W. The urinary excretion of testosterone and epitestosterone in females following intravenous infusions of testosterone before and during treatment with an antiandrogen (cyproterone). Acta Endocrinol (Copenh) 1968 Nov;59(3):454–458. doi: 10.1530/acta.0.0590454. [DOI] [PubMed] [Google Scholar]
  26. Vanderschueren-Lodeweyckx M., Eggermont E., Cornette C., Beckers C., Malvaux P., Eeckels R. Decreased serum thyroid hormone levels and increased TSH response to TRH in infants with coeliac disease. Clin Endocrinol (Oxf) 1977 May;6(5):361–367. doi: 10.1111/j.1365-2265.1977.tb02022.x. [DOI] [PubMed] [Google Scholar]
  27. Vanderschueren-Lodeweyckx, Wolter R., Molla A., Eggermont E., Eeckels R. Plasma growth hormone in coeliac disease. Helv Paediatr Acta. 1973 Oct;28(4):349–357. [PubMed] [Google Scholar]
  28. Vosbeck K., Keller P. J. The influence of antiandrogens on the excretion of FSH, LH AND 17-ketosteroids in males. Horm Metab Res. 1971 Jul;3(4):273–276. doi: 10.1055/s-0028-1094147. [DOI] [PubMed] [Google Scholar]
  29. Walsh P. C., Madden J. D., Harrod M. J., Goldstein J. L., MacDonald P. C., Wilson J. D. Familial incomplete male pseudohermaphroditism, type 2. Decreased dihydrotestosterone formation in pseudovaginal perineoscrotal hypospadias. N Engl J Med. 1974 Oct 31;291(18):944–949. doi: 10.1056/NEJM197410312911806. [DOI] [PubMed] [Google Scholar]
  30. Willoughby J. M., Beckett J., Kumar P. J., Dawson A. M. Controlled trial of azathioprine in Crohn's disease. Lancet. 1971 Oct 30;2(7731):944–947. doi: 10.1016/s0140-6736(71)90268-6. [DOI] [PubMed] [Google Scholar]
  31. Zioudrou C., Streaty R. A., Klee W. A. Opioid peptides derived from food proteins. The exorphins. J Biol Chem. 1979 Apr 10;254(7):2446–2449. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES