Glucocorticoid Induced Hypothalamic-Pituitary Axis Alterations Associated with Hypogonadotropic Hypogonadism

Authors

  • Navid Mahabadi, A.T. Still University, School of Osteopathic Medicine, Mesa, Arizona, USA
  • Ashley Doucet A.T. Still University, School of Osteopathic Medicine, Mesa, Arizona, USA
  • Andrew Lun Wong Division of Rheumatology, Olive View-UCLA Medical Center, Sylmar, California, USA
  • Vahid Mahabadi Division of Endocrinology, Olive View-UCLA Medical Center, Sylmar, California, USA

DOI:

https://doi.org/10.17140/ORHOJ-2-109

Keywords:

Glucocorticoid; HPA axis; Hypogonadotropic hypogonadism; Testosterone; Rheumatic disease.

Abstract

Since the existence of cortisol in 1930 to current multiple formulations of glucocorticoids, it has been one of the most wide-spread medications to use for the treatment of simple to serious maladies. Glucocorticoids have gained unprecedented impor-tance in treating autoimmune and inflammatory diseases, with one study conducted between 1998-2008 signifying that 1.2% of Americans over the age of 20 were at one point on glucocorticoid therapy, accounting for approximately 2.5 million Americans over the course of a decade. In this brief review, we focused on consequences of glucocorticoid therapy on alteration of sex steroids mainly in men with subsequent low libido, fatigue, erectile dysfunction, loss of muscle mass, increasing adipose tissue and osteoporosis. Effects of glucocorticoids appraised, based on current and available evidence at the level of the hypothalamus and pituitary, could cause alteration on the adipocyte-kisspeptin-gonadotropin-releasing hormone (GnRH)-luteinizing hormone (LH)-follicle-stimulating hormone (FSH) axis, especially with long-term use. The resultant hypogonadism occurs by suppression of GnRH-receptors, GnRH, LH, and FSH. Hypogonadism in patients with rheumatological diseases has multiple reasons, one of which is functional due to current illness and alteration in cytokines and inflammatory markers, and the other is a consequence of glucocorticoid therapy, which in either situation treatment of hypogonadism may improve quality of life and prevent complica-tions of hypogonadism.

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Published

2025-09-11

How to Cite

Navid Mahabadi, Ashley Doucet, Andrew Lun Wong, & Vahid Mahabadi. (2025). Glucocorticoid Induced Hypothalamic-Pituitary Axis Alterations Associated with Hypogonadotropic Hypogonadism. Osteology and Rheumatology, 2(1), 1–5. https://doi.org/10.17140/ORHOJ-2-109

Issue

Vol. 2 No. 1 (2019): Volume 2 Issue 1 2019

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Articles

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