It is known that
prostate specific antigen (PSA) is strongly
androgen dependent, but little is known about the effects of
gonadotropin and
testosterone treatments on the prostate and serum PSA levels in male
hypogonadism. We have therefore determined serum PSA levels before and 3 months
after treatment in 13 patients with
idiopathic hypogonadotropic hypogonadism (IHH) and 14 patients with
Klinefelter's syndrome. Plasma FSH, LH,
testosterone, PRL, testis and prostate volumes were also determined before and 3 months
after treatments. Patients with IHH were treated with hCG/hMG and patients with
Klinefelter's syndrome received
testosterone treatment. PSA levels were determined by a kinetic
enzyme immunoassay method. In patients with
Klinefelter's syndrome FSH and LH levels were significantly decreased but total and free
testosterone and PSA levels were significantly increased after 3 months of treatment. Right and left testicular volumes were not significantly changed whereas prostate volumes were significantly increased
after treatment. In this group PSA levels were significantly and positively correlated with the prostate volume both before (r=0.54, P=0.048) and
after treatment (r=0.61, P=0.012). In the IHH group total and free
testosterone and PSA levels were significantly increased after
gonadotropin treatment but FSH and LH levels did not change significantly. Right and left testicular volumes and the prostate volumes were also significantly increased after 3 months of
gonadotropin treatment. In this group PSA levels were correlated with prostate volume before (r=0.74, P=0.004) treatment but not after
therapy (r=0.35, P=NS). Our results show that serum PSA levels increase after
gonadotropin and
testosterone treatment in male
hypogonadism, but this could not be used as an index for the evaluation of the
androgen action in the treatment of male
hypogonadism, since PSA levels following treatments were correlated with the prostate volume or T levels only in patients with
Klinefelter's syndrome but not in the IHH group.