What is the Origin of Pituitary Recrudescence?

This concept is derived from clinical endocrinology and pharmacology, addressing the reversibility of the suppressive effects of negative feedback. "Recrudescence" comes from the Latin recrudescere, meaning to break out afresh, signifying a return to an active, functional state. Its clinical importance grew with the need to manage fertility concerns in men undergoing testosterone replacement or using anabolic steroids.

What is the Mechanism of Pituitary Recrudescence?

Exogenous testosterone induces negative feedback on the Hypothalamic-Pituitary-Gonadal (HPG) axis, leading to a profound suppression of GnRH release from the hypothalamus and subsequent LH and FSH release from the pituitary gonadotrophs. Pituitary recrudescence is initiated when the negative feedback signal is removed, allowing the hypothalamus to resume its GnRH pulsatility. This renewed signaling stimulates the pituitary to synthesize and release LH and FSH, which then travel to the testes to restart the necessary steroidogenesis and sperm production.

Pituitary Recrudescence

Meaning

Pituitary recrudescence describes the clinical phenomenon of the pituitary gland’s suppressed function spontaneously or pharmacologically recovering, specifically its ability to resume the pulsatile secretion of gonadotropins. This term is most often used in the context of male fertility preservation after the cessation of exogenous steroid or testosterone administration, where the pituitary must restart the production of Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH). Successful recrudescence is necessary for the restoration of endogenous testosterone production and spermatogenesis.