Testicular dysfunction in men affected by lepromatous leprosy

Objective: To assess the levels of testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) in adult males affected by lepromatous leprosy. Methodology: This cross-sectional study included 40 men (age 41·78 ^ 13·35 years; mean ^SD) affected by lepromatous leprosy from leprosy clinics in Dhaka and Nilphamari, Bangladesh, who were either receiving multi-drug therapy (MDT) for leprosy (n 1⁄4 23) or were released from treatment (RFT; n 1⁄4 17). Clinical data were recorded while serum testosterone, LH and FSH were assayed by enzyme immunoassay (EIA). Results: Serum testosterone was low in 12 (30%) participants, while 16 (40%) had a normal testosterone level but elevated LH and FSH. Testicular volume was lowest in those with a low testosterone level, followed by those with a normal testosterone but elevated LH and FSH levels, and highest in those who had all these hormones within the normal range (11·42 ^ 1·33 ml vs. 16·97 ^ 1·25 ml vs. 22·50 ^ 1·01 ml respectively; mean ^SEM; P , 0·001). The frequency of erythema nodosum leprosum (ENL) was observed to follow a similar pattern (low testosterone vs. normal testosterone but elevated LH, FSH vs. all normal: 83·3% vs. 68·8% vs. 33·3%, P 1⁄4 0·033). There was a significant negative correlation between the testosterone level and the bacillary index (r 1⁄4 2442, P 1⁄4 0·010) and the presence of ENL (r 1⁄4 20·331, P 1⁄4 0·037), and a positive correlation with testicular volume (r 1⁄4 464, P 1⁄4 0·003). LH and FSH also had significant negative correlation with testicular volume (r 1⁄4 20·554, P , 0·001 and r 1⁄4 20·601, P , 0·001 respectively). In conclusion, nearly one third men affected by lepromatous leprosy people had low testosterone. The testosterone level correlated positively with testicular volume and negatively with bacillary load and ENL.