Cushings syndrome is rare in males. Hypercortisolic consequences on male gonadal function are unknown. The aim of our study is to research gonadal and sexual abnormalities in 17 male subjects with endogenous cortisol excess: 10 Cushings diseases, 5 paraneoplastic Cushing syndrome, 1 malignant corticosurrenaloma, 1 micronodular dysplasia. Their mean age is 30.2 years (18 50). Our work is based on anamnestic, clinical and hormonal results. Our population is compared to normal men without medical or endocrinological diseases. Nobody has taken medical treatment before or during biological exploration.
Our results are as follow: decreased libido and/or impotency is noticed in 7/15 subjects (46%), there is a gynecomastia in one case (5.8%) and testosterone of hypercortisolic subjects is significantly lower than testosterone of normal subjects (2.9 ng/ml versus 5.05, P<0.01). Mean prolactine (PRL) of our population is higher than PRL of control group (11 ng/ml versus 2.5, P<0.005). For gonadotrophines there is no difference between the two groups (FSH of hypercortisolic subjects =4.2 mU/ml versus 3.3 and LH=2.9 mU/ml versus 3.0, P>0,05).
Conclusion: Men with endogenous hypercortisolism have a decreased libido and/or impotency in 46%. Their testosterone is significantly lower than normal subjects and their prolactine is higher. Gonadotrophines of hypercortisolic group are similar to those of control group. The mechanism of this normogonadotrop hypogonadism will be discussed.