A 31-year-old man presenting with an 18-month history of sexual dysfunction resulting from severe adult-onset IHH (LH U/L, FSH U/L, T nmol/L). Initial therapy with 50 mg of clomiphene citrate (CC) three times a day for 7 days, with overnight LH pulse profiling and 9 am T levels evaluated at baseline and on completion. A 2-month washout period, followed by low-dose maintenance therapy (25-50 mg/d) for 4 months.
MAIN OUTCOME MEASURE(S):Baseline and stimulated T levels and LH pulsatility; effect on sexual function.
RESULT(S):Clomiphene therapy resulted in complete normalization of pulsatile gonadotropin secretion, serum T level, and sexual function. CONCLUSION(S):Isolated hypogonadotropic hypogonadism may result from an acquired defect of enhanced hypothalamic sensitivity to E-mediated negative feedback. Whereas direct T replacement therapy can further suppress endogenous gonadotropin secretion, treating IHH men with gonadotropins can stimulate endogenous T secretion and enhance fertility potential. On theoretical grounds, reversal of gonadotropin deficiency with CC might be expected to have a similar biological effect.
Er, it seems like intermittent fasting generally reduces testosterone production. For example, in Dr. John Berardi’s experiments with intermittent fasting, his testosterone levels dropped from nmol/L to nmol/L after 6 months. The reason for that is probably fairly simple: testosterone is sensitive to energy balance. When you’re not eating enough calories overall, your testosterone will drop. Since the whole purpose of intermittent fasting is to drop you into a calorie deficit, it can reduce testosterone production. Mind you, the different Dr. Berardi experienced was hardly anything, and he got fantastic results, so intermittent fasting certainly worked great for him.
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