Abstract
The hormonal mechanisms involved in the development of gynaecomastia accompanying the treatment of multiple myeloma in adult men have been investigated by studying levels of circulating testosterone (T), oestrone (EI), oestradiol (E2), sex-hormone binding globulin (SHBG), prolactin (PRL) and the gonadotrophins LH and FSH, before, during and after development of gynaecomastia in 4 men. These have been compared with 5 closely matched men who did not develop gynaecomastia during similar treatment for myeloma. Levels of circulating T fell, and levels of E1 and E2 rose during treatment periods in all subjects, and the changes were statistically significant in subjects developing gynaecomastia, which resolved as levels of sex steroid returned towards normal following cessation of treatment. We conclude that treatment of adult men for myeloma results in testicular dysfunction with a reduction in circulating T and a rise in circulating oestrogens. These changes are most marked in subjects developing gynaecomastia in whom the normal breast tissue is stimulated by a subtle, transient oestrogen:androgen imbalance in favour of oestrogens.
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- Anderson D. C., Hopper B. R., Lasley B. L., Yen S. S. A simple method for the assay of eight steroids in small volumes of plasma. Steroids. 1976 Aug;28(2):179–196. doi: 10.1016/0039-128x(76)90108-2. [DOI] [PubMed] [Google Scholar]
- Anderson D. C., Lasley B. L., Risher R. A., Shepherd J. H., Newman L., Hendrickx A. G. Transplacental gradients of sex-hormone-binding globulin in human and simian pregnancy. Clin Endocrinol (Oxf) 1976 Nov;5(6):657–669. doi: 10.1111/j.1365-2265.1976.tb03869.x. [DOI] [PubMed] [Google Scholar]
- 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]
- Baird D. T., Galbraith A., Fraser I. S., Newsam J. E. The concentration of oestrone and oestradiol-17 in spermatic venous blood in man. J Endocrinol. 1973 May;57(2):285–288. doi: 10.1677/joe.0.0570285. [DOI] [PubMed] [Google Scholar]
- Doerr P., Pirke K. M. Regulation of plasma oestrogens in normal adult males. I. Response of oestradiol, oestrone and testosterone to HCG and fluoxymesterone administration. Acta Endocrinol (Copenh) 1974 Mar;75(3):617–624. [PubMed] [Google Scholar]
- Dorrington J. H., Armstrong D. T. Follicle-stimulating hormone stimulates estradiol-17beta synthesis in cultured Sertoli cells. Proc Natl Acad Sci U S A. 1975 Jul;72(7):2677–2681. doi: 10.1073/pnas.72.7.2677. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dorrington J. H., Fritz I. B., Armstrong D. T. Control of testicular estrogen synthesis. Biol Reprod. 1978 Feb;18(1):55–64. doi: 10.1095/biolreprod18.1.55. [DOI] [PubMed] [Google Scholar]
- GALTON D. A., TILL M., WILTSHAW E. Busulfan (1, 4-dimethanesulfonyloxybutane, myleran); summary of clinical results. Ann N Y Acad Sci. 1958 Apr 24;68(3):967–973. doi: 10.1111/j.1749-6632.1958.tb42652.x. [DOI] [PubMed] [Google Scholar]
- Hsueh A. J., Dufau M. L., Catt K. J. Direct inhibitory effect of estrogen on Leydig cell function of hypophysectomized rats. Endocrinology. 1978 Oct;103(4):1096–1102. doi: 10.1210/endo-103-4-1096. [DOI] [PubMed] [Google Scholar]
- Huhtaniemi I., Leinonen P., Hammond G. L., Vihko R. Effect of oestrogen treatment on testicular LH/HCG receptors and endogenous steroids in prostatic cancer patients. Clin Endocrinol (Oxf) 1980 Dec;13(6):561–568. doi: 10.1111/j.1365-2265.1980.tb03424.x. [DOI] [PubMed] [Google Scholar]
- Large D. M., Anderson D. C. Twenty-four hour profiles of circulating androgens and oestrogens in male puberty with and without gynaecomastia. Clin Endocrinol (Oxf) 1979 Nov;11(5):505–521. doi: 10.1111/j.1365-2265.1979.tb03103.x. [DOI] [PubMed] [Google Scholar]
- Longcope C., Kato T., Horton R. Conversion of blood androgens to estrogens in normal adult men and women. J Clin Invest. 1969 Dec;48(12):2191–2201. doi: 10.1172/JCI106185. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Martikainen H., Huhtaniemi I., Vihko R. Response of peripheral serum sex steroids and some of their precursors to a single injection of hCG in adult men. Clin Endocrinol (Oxf) 1980 Aug;13(2):157–166. doi: 10.1111/j.1365-2265.1980.tb01037.x. [DOI] [PubMed] [Google Scholar]
- Rosner W. A simplified method for the quantitative determination of testosterone-estradiol-binding globulin activity in human plasma. J Clin Endocrinol Metab. 1972 Jun;34(6):983–988. doi: 10.1210/jcem-34-6-983. [DOI] [PubMed] [Google Scholar]
- Rowley M. J., Leach D. R., Warner G. A., Heller C. G. Effect of graded doses of ionizing radiation on the human testis. Radiat Res. 1974 Sep;59(3):665–678. [PubMed] [Google Scholar]
- Rubens R., Dhont M., Vermeulen A. Further studies on Leydig cell function in old age. J Clin Endocrinol Metab. 1974 Jul;39(1):40–45. doi: 10.1210/jcem-39-1-40. [DOI] [PubMed] [Google Scholar]
- Saez J. M., Haour F., Loras B., Sanchez P., Cathiard A. M. Oestrogen induced Leydig cell refractoriness to gonadotrophin stimulation. Acta Endocrinol (Copenh) 1978 Oct;89(2):379–392. doi: 10.1530/acta.0.0890379. [DOI] [PubMed] [Google Scholar]
- Schalch D. S., Parlow A. F., Boon R. C., Reichlin S. Measurement of human luteinizing hormone in plasma by radioimmunoassay. J Clin Invest. 1968 Mar;47(3):665–678. doi: 10.1172/JCI105762. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schorer A. E., Oken M. M., Johnson G. J. Gynecomastia with nitrosourea therapy. Cancer Treat Rep. 1978 Apr;62(4):574–576. [PubMed] [Google Scholar]
- Shalet S. M. Effects of cancer chemotherapy on gonadal function of patients. Cancer Treat Rev. 1980 Sep;7(3):141–152. doi: 10.1016/s0305-7372(80)80028-4. [DOI] [PubMed] [Google Scholar]
- Smith R. H., Barrett O., Jr Gynecomastia associated with vincristine therapy. Calif Med. 1967 Oct;107(4):347–349. [PMC free article] [PubMed] [Google Scholar]
- Whitehead E., Shalet S. M., Blackledge G., Todd I., Crowther D., Beardwell C. G. The effects of Hodgkin's disease and combination chemotherapy on gonadal function in the adult male. Cancer. 1982 Feb 1;49(3):418–422. doi: 10.1002/1097-0142(19820201)49:3<418::aid-cncr2820490304>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]