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December 2, 1944


Author Affiliations

Los Angeles. Clinical Professor of Medicine, College of Medical Evangelists.

JAMA. 1944;126(14):914. doi:10.1001/jama.1944.02850490048023

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To the Editor:—  Among the numerous male patients complaining of various functional nervous disorders, including sexual impotence, Heller and Myers (The Journal, October 21, p. 472) found 23 who had pronounced elevation in gonadotropic hormone excretion, comparable quantitatively to that occurring in castrates. Testicular biopsy done on 8 of these patients revealed reduction in size and in activity of the seminiferous tubules and reduction in size and number of Leydig cells. Three times hyalinization of the seminiferous tubules was found. The age of those patients varied from 25 years to the seventh decade. They made a striking improvement after parenteral administration of testosterone propionate. They are considered to be "true examples of the male climacteric." Heller and Myers emphasize that their findings are by no means a physiologic accompaniment of the aging process in the male. "It is a relatively rare syndrome, probably affecting only a small proportion of men

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