Pituitary-Testicular Axis Dysfunction in Spinal Cord Injury

  • N. E. Naftchi
  • A. T. Viau
  • G. H. Sell
  • E. W. Lowman


Concentrations of testosterone luteinizing hormone (LH), follicle — stimulating hormone (FSH) in serum, and 17-ketosteroids (17-KS) in urine of 10 paraplegic and 10 quadriplegic subjects were measured from the date of onset of the injury and were followed once a week for a period of four months. In paraplegic subjects, serum LH and FSH levels were significantly lower than those of the age-matched, normal controls for a period of two weeks and those of testosterone for six weeks after spinal cord trauma, respectively. Following the above periods of time, serum concentrations of those hormones were not significantly different from those of the controls. By contrast, in quadriplegic subjects serum testosterone concentrations remained significantly lower than those of the controls during the entire four-month testing period. Furthermore, in another group of 10 chronic quadriplegic subjects, serum testosterone and FSH concentrations were comparable to those of the normal controls. Serum LH concentrations were at control levels in chronic paraplegic, but they were significantly depressed in chronic quadriplegic subjects. The concentration of urinary 17-KS exhibited sharp fluctuations over the four-month period and were below control levels in paraplegic but within control limits in quadriplegic subjects. The results indicate that the function of the hypothalamic-pituitary-gonadal axis is disturbed for at least four months in quadriplegic subjects.


Spinal Cord Injury Luteinizing Hormone Serum Testosterone Spinal Cord Trauma Serum Luteinizing Hormone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Aono, T., Kurachi, K., Miyata, M., Nakasima, A., Koshiyama, K., Uozumi, T., and Matsumoto, K. Influence of surgical stress under general anesthesia on serum gonadotropin levels in male and female patients. J. Clin. Endocrinol. 42: 144 (1976).CrossRefGoogle Scholar
  2. Bors, E., Engle, E.T., Rosenquist, R.C., and Holliger, V.H. Fertility in paraplegic males. A preliminary report of endocrine studies. J. Clin. Endocrinol. 10: 381 (1950).CrossRefGoogle Scholar
  3. Bradlow, H.L. Extraction of steroid conjugates with neutral resin. Steroids 11: 265 (1968).PubMedCrossRefGoogle Scholar
  4. Charters, A.C., Odell, W.D., and Thompson, J.C. Anterior pituitary function during surgical stress and convalescence. Radioimmunoassay measurement of blood TSH, LH, FSH and growth hormone. J. Clin. Endocrinol. Metab. 29: 63 (1969).PubMedCrossRefGoogle Scholar
  5. Chen, J.C., Zorn, E.M., Hallberg, M.C., and Wieland, R.G. Antibodies to testosterone-3-bovine serum albumin, applied to assay of serum 17B-ol androgens. Clin. Chem. 17: 581 (1971).PubMedGoogle Scholar
  6. Claus-Walker, J., Scurry, M., Carter, R.E., and Campos, R.J. Steady state hormonal secretion in traumatic quadriplegia. J. Clin. Endocrinol. Metab. 44: 530–535 (1977).PubMedCrossRefGoogle Scholar
  7. Cook, A.W., and Lyons, H.A. Urinary excretion of 17-ketosteroids in tetraplegic and paraplegic patients. A preliminary metabolic report. U.S. Armed Forces Med. J. 1: 583 (1950).PubMedGoogle Scholar
  8. Cooper, I.S., and Hoen, T.I. Gynacomastia in paraplegic males. Report of seven cases. J. Clin. Endocrinol. 9: 457 (1949).CrossRefGoogle Scholar
  9. Cooper, I.S., Rynearson, E.H., MacCarty, C.S., and Power, M.H. Metabolic consequences of spinal cord injury. J. Clin. Endocrinol. 10: 858 (1950).CrossRefGoogle Scholar
  10. Cooper, I.S., and Hoen, T.I. Metabolic disorders in paraplegics. Neurology 2: 332 (1952).PubMedGoogle Scholar
  11. Cooper, I.S., MacCarty, C.S., and Rynearson, E.H. Gynecomastia in paraplegic males. J. Neurosurg. 7: 364 (1950).PubMedCrossRefGoogle Scholar
  12. Faerman, I., Vilar, O., Rivarola, M.A., Rosner, J.M., Jadzinsky, M.N., Fox, D., Perez Lloret Perez, A., Bernstein-Hahn, L., and Saraceni, D. Impotence and diabetes. Studies of androgenic function. Diabetes 21: 23 (1972).PubMedGoogle Scholar
  13. Fontaine, R., Dany, A., Muller, J.N., and Holderbach, L. Le traitement des paraplegies traumatiques. Rev. Neurol. 86: 416 (1952).PubMedGoogle Scholar
  14. Forbes, A.P., Donaldson, E.C., Reifenstein, E.C., Jr., and Albright, F.J. The effect of trauma and disease on the urinary 17-ketosteroid excretion in man. J. Clin. Endocrinol. 7: 264 (1947).CrossRefGoogle Scholar
  15. Home, H.W., Paull, D.P., and Munro, D. Fertility studies in the human male with traumatic injuries of the spinal cord and cauda equina. New Engl. J. Med. 239: 959 (1948).CrossRefGoogle Scholar
  16. Kent, J.R., Scaramuzzi, R.J., Lauwers, W., Parlow, A., Hill, M., Penardi, R., and Hilliard, J. Plasma testosterone, estradiol and gonadotropins in hepatic insufficiency. Gastroenterology 64: 111 (1975).Google Scholar
  17. Keye, J.D. Hyperplasia of Leydig cells in chronic paraplegia. Neurology 6: 68 (1956).PubMedGoogle Scholar
  18. Kikuchi, T., Showsky, R., Eltoraei, I., and Swerdloff, R. The pituitary-gonadal axis in spinal cord injury, Clin. Res. 23: 238A (1975).Google Scholar
  19. Klein, M., Fontaine, R., Stoll, G., Dany, A., and Frank, P. Modifications histologiques des testicules chez les paraplegiques. Rev. Neurol. 86: 501 (1952).PubMedGoogle Scholar
  20. Krueger, H.M., Hodgen, G.D., and Sherins, R.J. New evidence for the role of Sertoli cell and spermatogonia in feedback control of FSH secretion in male rats. Endocrinology 95: 955 (1974).PubMedCrossRefGoogle Scholar
  21. Leonard, J.M., Leach, R.B., Couture, M., and Paulsen, C.A. Plasma and urinary follicle-stimulating hormone levels in oligaspermia. J. Clin. Endocrinol. Metab. 34: 209 (1977).CrossRefGoogle Scholar
  22. Levy, S., and Schwartz, T. A simple colorimetric method for the extraction and determination of urinary 17-ketosteroids using styrene divinylbenzene copolymer XAD — 2 resin columns. Clin. Chem. 19: 679 (1973).Google Scholar
  23. Matusmoto, K., Takeyasu, K., Mizutani, S., Hamanaka, Y., and Uozumi, T. Plasma testosterone levels following surgical stress in male patients, Acta Endocrinol. 65: 11 (1970).Google Scholar
  24. Midgley, A.R., Jr. Radioimmunoassay: a method for human chorionic gonadotropin and human luteinizing hormone. Endocrinology 79: 10 (1966).PubMedCrossRefGoogle Scholar
  25. Midgley, A.R., Jr. Radioimmunoassay for human follicle stimulating hormone. J. Clin. Endocrinol. Metab. 27: 295 (1967).PubMedCrossRefGoogle Scholar
  26. Mizutani, S., Sonoda, T., Matsumoto, K., and Iwasa, K. Plasma testosterone concentration in paraplegic men. J. Endocrinol. 54: 363 (1972).PubMedCrossRefGoogle Scholar
  27. Monden, Y., Koshiyama, K., Tanaka, H., Mizutani, S., Aono, T., Hamanaka, Y., Uozumi, T., and Matsumoto, K. Influence of major surgical stress on plasma testosterone, plasma LH, and urinary steroids. Acta Endocrinol. 69: 542 (1972).PubMedGoogle Scholar
  28. O’Connell, F.B., Jr., and Gardner, W.J. Metabolism in paraplegia. JAMA 153: 706 (1953).CrossRefGoogle Scholar
  29. Stemmermann, G.N., Weiss, L., Auerbach, O., and Friedman, M. A study of the germinal epithelium in male paraplegics. Amer. J. Clin. Path. 20: 24 (1950).Google Scholar
  30. Steinberger, A., and Steinberger, E. Secretion of an FSH-inhibiting factor by cultured Sertoli cells. Endocrinology 99: 918 (1976).PubMedCrossRefGoogle Scholar
  31. Talbot, H.S. The sexual function in paraplegia. J. Urol. 73: 91 (1955).PubMedGoogle Scholar

Copyright information

© Spectrum Publications, Inc. 1982

Authors and Affiliations

  • N. E. Naftchi
  • A. T. Viau
  • G. H. Sell
  • E. W. Lowman

There are no affiliations available

Personalised recommendations