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Andrology

Ibuprofen and hypogonadism — bench to bedside to misinterpreted hype?

Nature Reviews Urology volume 15, pages 268–269 (2018)Cite this article

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A recent study suggests modulation of luteinizing hormone signalling within the hypothalamic–pituitary–gonadal axis and downstream transcriptional effects caused by sustained ibuprofen use. However, this study cannot be used to draw any clinical conclusions regarding effects of ibuprofen on male androgenic or reproductive health. Thus, the andrological effects of its use remain unclear and would benefit from further investigation.

The concept of non-steroidal anti-inflammatory drugs (NSAIDs) affecting steroidogenesis, and specifically reproductive and androgenic hormones, is not new — evidence is available in the literature from the 1970s onwards1,2. A new study published by Kristensen and colleagues3 is unique because of its 'bench-to-bedside' approach: in vitro and ex vivo studies and an associated clinical trial. The authors demonstrate a negative correlation between ibuprofen titration and hormone production, steroidogenic gene expression, and prostaglandin transcription using a human steroidogenic cell line in vitro and an ex vivo human testicular tissue model. The small, randomized, double-blind, placebo-controlled trial showed a positive correlation between plasma levels of luteinizing hormone (LH) and ibuprofen. Testosterone levels were normal, and so the authors referred to this state as 'compensated hypogonadism'.

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Acknowledgements

The authors would like to thank Brian Chase, biostatistician in the Department of Urology, University of Kansas Health System, for his comments on the statistics of the paper under discussion.

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  1. Department of Urology, University of Kansas Health System, Kansas City, KS, USA

    Ajay K. Nangia & Derek Jensen

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  1. Ajay K. Nangia
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A.N. wrote the manuscript. Both authors researched data for the article, took part in discussions of content, and reviewed and edited the manuscript before submission.

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Correspondence to Ajay K. Nangia.

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Nangia, A., Jensen, D. Ibuprofen and hypogonadism — bench to bedside to misinterpreted hype?. Nat Rev Urol 15, 268–269 (2018). https://doi.org/10.1038/nrurol.2018.26

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