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

NCJ Number
201561
Journal
Journal of Forensic Sciences Volume: 48 Issue: 4 Dated: July 2003 Pages: 849-855
Author(s)
Linda J. Grasswick M.D.; John M. W. Bradford M.B.
Date Published
July 2003
Length
7 pages
Annotation
This article reports on a case study of seven patients treated with long-term androgen suppression for severe paraphilias.
Abstract
The treatment of paraphilias usually involves a combination of cognitive-behavioral and pharmacological interventions, with the goal of reducing sexually deviant fantasies and behaviors. The seven patients were divided into two groups based on level of androgen suppression; one group consisted of castration levels of testosterone (either surgically castrated or treated with GnRH agonists), while the other group consisted of normal or low-normal testosterone levels (treated with CPA). The goal of the study was to determine the effects of these treatments on the formation of osteoporosis in the patients. Two of the four patients treated with CPA developed significant osteoporosis while the other two patients treated with CPA presented with normal bone density. Of the remaining three patients, the two treated with surgical castration and the one treated with GnRH agonists presented with osteopenia. The results are surprising given the current research literature which points to CPA treatment as being protective against the development of osteoporosis. Implications of the study include the careful monitoring of all patients treated with long-term androgen suppression for osteoporosis. Tables, references

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