Age in Men Does Not Determine Gonadotropin-Releasing Hormone's Dose-Dependent Stimulation of Luteinizing Hormone Secretion under an Exogenous Testosterone Clamp

Background: Aging is associated with a decline in incremental LH pulse amplitude, which could be due to decreased GnRH secretion or impaired GnRH action. Hypothesis: Inconsistent published studies of GnRH action in older men may be due to disparate sex-steroid milieus. Facility: This study was conducted at a clinical translational-research unit. Subjects: We studied 16 healthy men (8 young men and 8 older men). Methods: An overnight transdermal testosterone (T) clamp was implemented before randomly ordered injections of 0, 2.5, 10, 25, 250, and 750 ng GnRH on separate days (96 study sessions). Outcomes: LH responses were quantified by variable-waveform deconvolution analysis. Results: The T clamp maintained age-invariant mean concentrations of total, bioavailable, and free T, SHBG, LH, FSH, and prolactin. By two-way analysis of covariance, GnRH dose(P < 0.001) but notage(0.15 <= P <= 0.83) determined mean, peak, incremental, and pulsatile LH responses. Statistical power (median) was 95, 98, 90, and 99% to detect a 30% or greater age contrast at P <= 0.05 in mean, peak, incremental, and pulsatile LH responses, and greater than 99% to detect a 30% or greater age contrast in bioavailable or total T concentrations. Higher GnRH doses (P < 0.001) abbreviated LH secretory bursts in both age groups. Conclusion: In the face of eugonadal concentrations of total, bioavailable, and free T, young and older men exhibit remarkably similar LH responses to a 300-fold dose range of exogenous GnRH. Accordingly, previously reported disparate effects of age on GnRH action may reflect in part age-discrepant sex-steroid milieus. (J Clin Endocrinol Metab 95: 2877-2884, 2010)