Andrological aspects of the effects of gonadotropinreleasing hormone agonists in experiment and clinic

Abstract

A literature search was made to study works devoted to the results of gonadotropinreleasing hormone agonists (GnRHa) using in men in clinical settings and male animals in experiments. Almost all researchers claim that GnRHa suppress testicular function. But there is no clear opinion regarding the mechanisms of this effect: some scientists believe that a direct effect of drugs on testicular cells is possible, others believe that such an effect is indirect through other hormones, including pituitary ones. Most published articles provide evidence of a decrease in mass with atrophy of prostate and seminal vesicle tissue after the use of GnRHa. The effect is similar to surgical castration, but appears somewhat later and sometimes less pronounced, since testosterone synthesis is not completely suppressed. In the complex therapeutic treatment of prostate cancer, drugs of this group provide comparable effectiveness to orchiectomy or high doses of estrogens, while a lower frequency of side effects has been recorded. GnRH has an antiproliferative effect on the cells of prostate carcinomas, but at the same time there is an opinion that GnRHa do not inhibit the proliferation of prostate cancer cells, and that direct suppression of mitotic activity is unlikely to be the main mechanism of the antitumor effect of such drugs. When studying the data on the protective effect of GnRH drugs on the cells and tissues of the genital organs during chemotherapy and radiation, attention is drawn to the obvious inconsistency of publications: from a good effect with a rapid restoration of functional activity, to weak or even completely absent positive dynamics. In any case, the inconsistency of publications on each aspect of the effects of GnRH indicates that they have been poorly studied, and the advisability of further continuing not only applied research, but also fundamental research, due to its possible high prospects.

Keywords

• gonadotropin-releasing hormone agonists
• male animals
• male patients
• testicles
• prostate gland
• testosterone
• prostate cancer