A 31-year-old man presenting with an 18-month history of sexual dysfunction resulting from severe adult-onset IHH (LH U/L, FSH U/L, T nmol/L). Initial therapy with 50 mg of clomiphene citrate (CC) three times a day for 7 days, with overnight LH pulse profiling and 9 am T levels evaluated at baseline and on completion. A 2-month washout period, followed by low-dose maintenance therapy (25-50 mg/d) for 4 months.
MAIN OUTCOME MEASURE(S):Baseline and stimulated T levels and LH pulsatility; effect on sexual function.
RESULT(S):Clomiphene therapy resulted in complete normalization of pulsatile gonadotropin secretion, serum T level, and sexual function. CONCLUSION(S):Isolated hypogonadotropic hypogonadism may result from an acquired defect of enhanced hypothalamic sensitivity to E-mediated negative feedback. Whereas direct T replacement therapy can further suppress endogenous gonadotropin secretion, treating IHH men with gonadotropins can stimulate endogenous T secretion and enhance fertility potential. On theoretical grounds, reversal of gonadotropin deficiency with CC might be expected to have a similar biological effect.
A survey of 28,000 users found that many Italian males started an "excessive consumption" of porn sites as early as 14 years old. After daily use in their early to mid-20s, they become inured to "even the most violent" images. The effects of developing their sexuality largely divorced from real-life relationships are gradual and devastating. "It starts with lower reactions to porn sites, then there is a general drop in libido and in the end it becomes impossible to get an erection," Carlo Foresta, head of the Italian Society of Andrology and Sexual Medicine (SIAMS), told reporters. However, the condition is not irreversible and a proper recovery is possible within just a few short months.