Behavioral and hormonal effects of prolonged high doses of LHRH in male impotency

Eight married men with secondary impotency on a nonorganic, non-psychiatric disease basis injected themselves with placebo subcutaneously (SC) twice a day (b.i.d.) for the first week in a single blind design followed by two periods of four weeks with LHRH (3 mg b.i.d. for four weeks) and placebo (b.i.d. for four weeks) in a double blind crossover design. Outcome was assessed by daily questionnaires. There were no significant differences between the effects of LHRH and placebo on frequency of intercourse, spontaneous erections, and wife's rating of her husband's libido. On these measurements, small, non-significant, trends toward improvement were associated with LHRH. The patients' rating of their own libido was higher (p<0.05) during the first week on LHRH compared to the first week of the four weeks of placebo, but the magnitude of the differences was minimal. Frequency of masturbation did not increase with LHRH. In contrast to other studies, men with premasturbatory activity improved less and there was no improvement in potency in the two month follow-up after LHRH. Baseline LH, FSH, testosterone and prolactin were all within normal limits. The LH and FSH response to LHRH decreased over the 28 days but testosterone levels and response to LHRH increased. Since there was a small trend toward improvement after LHRH, clinical trials with LHRH analogs should be explored.