Alcohol, Levercirrose, En Stoornissen in Het Metabolisme Van De Geslachtshormonen

SummaryAbnormalities in the metabolism of sex hormones are frequently observed in cirrhotic patients, especially in chronic alcoholics. Signs of hypogonadism with’Curbed reproductive and endocrine gonadal functions are found in men as well as in women. Primary hypogonadism as well as hypothalamic-pituitary inhi-Uion seem to play a role. Primary gonadal insufficiency is the result of a direct toxic effect of ethanol and of acetaldehyde on the gonads with inhibition of L.H binding to the Leydig cells, with inhibition of the, Byrnes responsible for the formation of sex hormomones and with inhibition of the intratesticular activation of vitamin A. Hypothalamic-pituitary hypogonadism results from a direct toxic effect of ethanol as well.as from the increasing concentrations of oestrogens in Plasma. Men with alcoholic cirrhosis may also be Chracterized by signs of feminization, which mainly result from an increased peripheral conversion of androgens.In men who abstain from alcohol, a spontaneous recovery of functions can occur, especially When no testicular atrophy is found and when the response of gonadotrophins after stimulation with LHRH is normal. Therapeutically, only the administration of non-aromatizable androgens in high doses seems to lead to recovery of potency.