Osteoporosis Associated with the Treatment of Paraphilias: A Clinical Review of Seven Case Reports

Osteoporosis and long-term androgen suppression in the treatment of paraphilias has been documented with surgical castration and the use of gonadotropin-releasing hormone agonists. The literature has suggested that the use of cyproterone acetate (CPA) may be protective against osteoporosis, although...

Full description

Saved in:
Bibliographic Details
Published in:Journal of forensic sciences 2003-07, Vol.48 (4), p.1-7
Main Authors: Grasswick, LJ, Bradford, JMW
Format: Article
Language:English
Subjects:
Adult
Androgen Antagonists - adverse effects
Bone Density
Cyproterone Acetate - adverse effects
Forensic Psychiatry
Humans
Leuprolide - therapeutic use
Male
Middle Aged
Osteoporosis
Osteoporosis - chemically induced
Paraphilic Disorders - drug therapy
Pilot Projects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Osteoporosis and long-term androgen suppression in the treatment of paraphilias has been documented with surgical castration and the use of gonadotropin-releasing hormone agonists. The literature has suggested that the use of cyproterone acetate (CPA) may be protective against osteoporosis, although there are case reports of osteoporosis in men treated with CPA. This pilot study represents a case series of seven patients diagnosed with severe paraphilias and treated with CPA, leuprolide, or surgical castration. Two of the four patients treated with CPA developed significant osteoporosis, while the other two had normal bone density studies. The remaining three patients, one treated with leuprolide and two with surgical castration, had osteopenia. Based upon the current literature, the finding of significant osteoporosis in two of four patients treated with CPA, but not those treated with leuprolide or castration, is surprising. Monitoring of all patients treated with long-term androgen suppression for osteoporosis is suggested.
ISSN:0022-1198
1556-4029
DOI:10.1520/JFS2002089