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Mes3.6

Mesterolone (Proviron) – Forschung

Überwiegend Mechanismus / Beobachtung

6 begutachtete Studien

Was die Evidenz sagt

Überwiegend Mechanismus / Beobachtung

Die meisten Studien zu Mesterolone (Proviron) sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.

Die meiste Evidenz stammt aus mittelwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 1983–2012 mit einer typischen Studiengröße von 52 Teilnehmenden.

Basierend auf 6 Studien · 1 Meta-Analyse · 3 RCTs · 346 Teilnehmende insgesamt

Konfidenz

Mittlere Konfidenz

Nach Outcome

Hormones & male vitalityEin von DHT abgeleitetes orales Androgen (Proviron) mit schwacher Evidenz für Libido/subjektive Vitalität; erhöht das freie Testosteron über die SHBG-Bindung, verbessert jedoch NICHT die Fruchtbarkeit und ist ein verschreibungspflichtiges/dopingrelevantes Androgen. · Wochen · Ein nicht-aromatisierbares exogenes Androgen, das an SHBG bindet, um das freie Testosteron zu erhöhen; unterdrückt die HPG-Achse in höheren Dosen mit DHT-vermittelten androgenen Effekten. · Wochen
Überwiegend Mechanismus / Beobachtung4 Studien
Fertility (largely negative)
Überwiegend Mechanismus / Beobachtung4 Studien
Safety profile
Zu wenige bewertete Studien1 Studie

Ältere Forschungsbasis

Neueste Studie von 2012 · Neueste Meta-Analyse: 2007

198319972012

1Meta-Analyse2007

There is not enough evidence to evaluate the use of androgens for male subfertility.

Vandekerckhove P, Lilford R, Vail A, Hughes E. · Cochrane Database Syst Rev (2007)

Cochrane systematic review of randomized trials of androgens — including mesterolone — vs placebo or no treatment for idiopathic oligo/asthenospermia
Eleven trials, 930 patients; for stimulatory androgen therapy (mesterolone, testosterone undecanoate) androgens had little effect on endocrine outcomes and sperm parameters
Pregnancy rate after stimulatory androgens vs placebo/no treatment was similar — odds ratio 1.10 (95% CI 0.75-1.61), crossing 1.0

Quelle ansehen

2RCTn=248 · medium study1989

There were no significant changes [in] semen quality during the course of the study... [pregnancy-rate] ratios compared to placebo were 1.3 (0.5-3.2) and 1.8 (0.7-4.4) for the 75 and 150 mg mesterolone groups respectively.

World Health Organization Task Force on the Diagnosis and Treatment of Infertility. · Int J Androl (1989)

Prospective randomized double-blind multicentre trial (7 centres, 248 infertile couples) of 75 or 150 mg/day mesterolone vs placebo for 6 months in idiopathic male infertility
Cumulative pregnancy-rate ratios vs placebo (1.3 and 1.8) had confidence intervals crossing 1.0 — no statistically significant fertility benefit
No significant change in semen quality attributable to mesterolone; an early sperm-concentration rise was actually greatest in the placebo group

3RCTn=52 · small study1991

The overall pregnancy rate was similar in the Mesterolone-treated cases (26%) and in the placebo control cases (48%)... our findings cast doubt on the possible usefulness of high-dose Mesterolone treatment of idiopathic male infertility.

Gerris J, Comhaire F, Hellemans P, Peeters K, Schoonjans F. · Fertil Steril (1991)

Double-blind trial of 150 mg/day mesterolone vs placebo for 12 months in 52 men with idiopathic oligoasthenoteratospermia
Pregnancy rate was actually higher in the placebo arm (48%) than the mesterolone arm (26%)
Although motility and normal morphology improved on mesterolone, similar improvement occurred on placebo — undercutting a treatment effect

Quelle ansehen

4RCTn=46 · small study1983

Treatment with the placebo, mesterolone, pentoxifylline, and testosterone rebound therapy did not result in a significant increase in the mean sperm concentration or pregnancy in the partners.

Wang C, Chan CW, Wong KK, Yeung KK. · Fertil Steril (1983)

Randomized comparison of placebo, clomiphene, mesterolone (100 mg/day), pentoxifylline, and testosterone rebound therapy in 46 men with idiopathic oligospermia
Mesterolone — like placebo — did NOT significantly increase mean sperm concentration or partner pregnancy
Only clomiphene significantly raised sperm concentration, illustrating that mesterolone's stimulatory rationale did not pan out

Quelle ansehen

5In vitro1984

1 alpha-Methyl-5 alpha-dihydrotestosterone (1 alpha-methyl-DHT; mesterolone) bound most avidly to sex hormone-binding globulin (SHBG) [relative binding affinity about 4 times that of DHT].

Saartok T, Dahlberg E, Gustafsson JA. · Endocrinology (1984)

Receptor-binding study comparing anabolic-androgenic steroids' affinity for the androgen receptor in muscle and prostate and for SHBG
Mesterolone (1α-methyl-DHT) bound SHBG about four times more avidly than DHT — the mechanistic basis for its SHBG-displacement / free-testosterone effect
Its androgen-receptor binding in muscle and prostate was relatively weak (below testosterone), consistent with it being a weak anabolic

Quelle ansehen

6Übersicht2012

In the presence of increased estrogen production symptoms... a short-term trial with non-aromatizable androgens (dihydrotestosterone mesterolone or oxandrolone) could be advisable. However, after a few months of therapy, switching to other aromatizable preparations is recommended, to prevent bone loss.

Corona G, Rastrelli G, Vignozzi L, Maggi M. · Expert Opin Emerg Drugs (2012)

Review of medications for male hypogonadism that situates mesterolone among non-aromatizable androgens
Notes mesterolone may be used short-term where estrogenic symptoms (gynecomastia/breast tenderness) are a concern, because it cannot aromatize
Cautions that because it is non-aromatizable, prolonged use risks bone loss — a switch to an aromatizable preparation is recommended

Quelle ansehen

In der Forschungsbibliothek ansehen

Mesterolone (Proviron) – Forschung

Überwiegend Mechanismus / Beobachtung

WITHDRAWN: Androgens versus placebo or no treatment for idiopathic oligo/asthenospermia.

Mesterolone and idiopathic male infertility: a double-blind study. World Health Organization Task Force on the Diagnosis and Treatment of Infertility.

Placebo-controlled trial of high-dose Mesterolone treatment of idiopathic male infertility.

Comparison of the effectiveness of placebo, clomiphene citrate, mesterolone, pentoxifylline, and testosterone rebound therapy for the treatment of idiopathic oligospermia.

Relative binding affinity of anabolic-androgenic steroids: comparison of the binding to the androgen receptors in skeletal muscle and in prostate, as well as to sex hormone-binding globulin.

Emerging medication for the treatment of male hypogonadism.