Pathogenesis And Symptomology Of The Exercise-hypogonodal Male Condition: 3683 Board #122 June 4, 9: 30 AM - 11: 00 AM.

PURPOSE: Men that engage in high volumes of long distance running have been shown to demonstrate low testosterone concentrations. However, the cause and consequences of this condition remain undetermined. The purpose of this study was to identify the pathogenesis of the condition as well as to determine whether symptoms that are typically seen in other populations with reduced testosterone are present. METHODS: 9 men (Age: 36.3 ± 9.2 years; Height: 180.0 ± 8.8 cm; Weight: 77.2 ± 6.8 kg) performing an average of 81 ± 14 km per week of running for the past 12 months (EHMC) were compared to 8 men who served as control (CONT) subjects (Age: 30.8 ± 6.3 years; Height: 176.9 ± 5.2; Weight: 77.3 ± 10.7 kg) performing no regular exercise for the past 12 months. Blood samples were taken every 15 minutes beginning at 08:00 and continuing until 12:00 and analyzed for testosterone (T), luteinizing hormone (LH), follicle stimulating hormone (FSH) and cortisol (C). Subjects underwent a dual x-ray absorptiometry (DEXA) scan to assess bone density and body composition. Subjects also completed the Aging Male Symptoms (AMS) questionnaire and a Food Frequency Questionnaire (FFQ). RESULTS: T concentrations were significantly (P ≤ 0.05) reduced in the EHMC group compared with CONT at all time points. There were no differences in LH. The EHMC group demonstrated significantly (P ≤ 0.05) higher AMS scores (EHMC: 26.0 ± 7.1 vs CONT: 21.7 ± 5.5). There were no differences in body composition or bone density. There were no differences in energy intake (EHMC: 2710.6 ± 800.1 vs CONT: 2742.8 ± 969.0 kcal). CONCLUSIONS: Reduced T concentrations resulting from long distance running leads to the demonstration of hypogonadal symptoms. Also, despite running an average of over 80 km per week at an estimated energy cost of 901 kcal/day, the EHMC group do not consume any more calories than their sedentary controls. Individual differences showed that some men may be protected against the reduced T response, while others may suffer particularly severe symptoms. Also, in some cases LH concentrations can be severely dampened, possibly due to an exhaustion of the GnRH neuron. Although long distance runners do exhibit symptoms of hypogonadism and thus warrant treatment, the symptoms are mostly minor and a carte blanche pharmaceutical intervention is not presently advised.