Human Reproduction, Vol. 13, No. 10, 2816-2818,
October 1998
© 1998 European Society of Human Reproduction and Embryology
Case report: Changes in bone mineral density after orchidectomy and hormone replacement therapy in individuals with androgen insensitivity syndrome
Department of Obstetrics and Gynecology, Gunma University School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371, Japan
Correspondence: To whom correspondence should be addressed
Changes in bone mineral density (BMD) after orchidectomy and after hormone replacement therapy were reported in two patients with complete androgen insensitivity syndrome (AIS). Diagnosis of AIS was made by clinical features and confirmed by the presence of 46,XY karyotype and the presence of testis component in the removed gonads. BMD at the lumbar spine and at three sites of the femur was measured by dual energy X-ray absorptiometry (DXA). The Z scores of the lumbar spine BMD before orchidectomy were -0.8 and -3.1, confirming that patients with AIS have low BMD and that androgen plays an important role in bone mineralization in 46,XY individuals. Castration reduced BMD, but treatment with daily doses of 1.25 mg of conjugated oestrogen and 10 mg of medroxyprogesterone acetate increased BMD. These results indicate that both oestrogen and androgen play an important role in balancing BMD in men.
Key words: androgen insensitivity syndrome/BMD/oestrogen/testicular feminization/testosterone
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