Effects of Testosterone Replacement Therapy in Old Hypogonadal Males: A Preliminary Study

Morley, John E.; Perry, Horace M.; Kaiser, Fran E.; Kraenzle, Dale; Jensen, Judy; Houston, Kathy; Mattammal, Michael B.; Perry, H. Mitchell

doi:10.1111/j.1532-5415.1993.tb02049.x

Cited by 425 publications

(204 citation statements)

References 25 publications

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“…In most of these studies, the body weight change did not differ significantly. Testosterone therapy was associated with a greater improvement in grip strength than placebo [37,74,75]. A recent double-blind placebo-controlled study showed benefits of testosterone administration on skeletal muscle performance in elderly men with chronic heart failure [76], and another one found positive effects on the prevention of loss of muscle strength of the lower limbs [77].…”

Section: Muscle Mass and Strengthmentioning

confidence: 99%

“…Long-term follow-up of testosterone replacement in hypogonadal males and a control group indicates that self-assessment of libido was significantly higher in the testosterone-treated group [50]. Testosterone replacement has also been shown to enhance libido and the frequency of sexual acts and sleep-related erections [75,89].…”

Section: Improved Sexual Desire Function and Performancementioning

confidence: 99%

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Androgens and male aging: current evidence of safety and efficacy

Gooren¹

2010

Asian J Androl

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Many signs of aging, such as sexual dysfunction, visceral obesity, impaired bone and muscle strength, bear a close resemblance to features of hypogonadism in younger men. The statistical decline of serum testosterone in aging men is solidly documented. It has been presumed that the above features of aging are related to the concurrent decline of androgens, and that correction of the lower-than-normal circulating levels of testosterone will lead to improvement of symptoms of aging. But in essence, the pivotal question whether the age-related decline of testosterone must be viewed as hypogonadism, in the best case reversed by testosterone treatment, has not been definitively resolved. Studies in elderly men with lower-than-normal testosterone report improvement of features of the metabolic syndrome, bone mineral density, of mood and of sexual functioning. But as yet there is no definitive proof of the beneficial effects of restoring testosterone levels to normal in elderly men on clinical parameters. Few of these studies meet as yet rigorous standards of scientific enquiry: double-blind, placebo-controlled design of the study. The above applies also to the assessment of safety of testosterone administration to elderly men. There is so far no convincing evidence that testosterone is a main factor in the development of prostate cancer in elderly men and guidelines for monitoring the development of prostate disease have been developed. It is of note that there are presently no long-term safety data with regard to the prostate. Polycythemia is another potential complication of testosterone treatment. It is dose dependent and can be managed with dose adjustment.

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Section: Muscle Mass and Strengthmentioning

confidence: 99%

Section: Improved Sexual Desire Function and Performancementioning

confidence: 99%

Androgens and male aging: current evidence of safety and efficacy

Gooren¹

2010

Asian J Androl

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“…Table 4 summarizes a number of studies demonstrating positive effects of testosterone replacement in men, similar to those seen with estrogen in women (25). In humans, testosterone increases muscle mass (26), muscle strength (27)(28)(29), bone mineral density (29,30), hemoglobin (28), and visuospatial cognitive function (31). Studies in the SAMP8 mouse, an animal model of Alzheimer disease (32), suggest that testosterone may play a role in the decline in memory and the overproduction of amyloid-6 protein seen in this species (14).…”

Section: The Hormonal Fountain Of Youthmentioning

confidence: 99%

Endocrine and metabolic changes in human aging

Banks

Morley

2000

AGE

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"Aging and death are inevitable. We have no desire to prolong life, if such prolongation entails only added days and years of misery and suffering. On the other hand, for the first time in history, man has within his grasp potent medications of many kinds, among the more important of which are specific hormones capable of retarding if not stopping some of the undesirable features of growing old". Thomas Hodge McGavack Geriatrics 18:181-191 (1963) ABSTRACT Numerous alterations in hormonal secretion occur with aging. In general, these tend towards a disintegration of the normal cyclic secretory patterns resulting in lower total circulating levels. In addition, declines in receptors and postreceptor function further decreases the ability of the hormonal orchestra to maintain coordinated function throughout the organism. Clues to some of these agerelated changes in humans may come from the study of simpler organisms where regulatory systems are known to modulate the aging process. In particular, the interactions among the environment, hormones, and insulin receptor genes have led to new insights into the genetic control of longevity and the development of syndrome X.It is now well established, as summarized in Table 1, that the levels of many hormones are altered with aging (1). Some hormonal levels decrease, reflecting endocrine gland failure, whereas others increase, often because of end organ failure due to a decrease in receptors or a failure of postreceptor function. In the last decade, it has become popular to look to hormone replacement therapy as a mechanism to reverse the aging process. It has become popular to consider this the "hormonal fountain of youth". With aging, dysregulation of food intake accompanied by sarcopenia ('wasting of the flesh") occurs (2). A number of hormonal mechanisms are related to the physiological anorexia of aging (3). In particular, recent studies have suggested that alterations in circulating testosterone levels lead in males to increased leptin levels and thus to anorexia (4).Another area of intense interest in understanding the mechanisms of aging in humans has been the alterations that occur in glucose metabolism with aging and the role of age-related glucose end products (AGE) in accelerating the aging process (5). This area has been closely linked with the changes in nutrition that occur with aging, with insulin resistance, and more recently, with the genes that encode for the insulin receptor. It is of interest that the hormonal changes produced by dietary restriction in rodents are similar to the agerelated hormonal changes in humans, as shown in Table 2 (6). This raises the possibility that these hormonal changes are protective, i,e. slow down metabolism and thus slow down the aging process. This creates a "chicken or egg" hypothesis, illustrated in Figure 1, which asks the question: do aging changes occur because of the decline in hormones or do high hormone levels produce aging changes?This review will briefly examine the available data in each of these areas and...

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“…There is some evidence suggestive of reduced bone turnover; testosterone enanthate 100 mg weekly for 3 months led to a reduction in urinary hydroxyproline excretion compared with placebo (Tenover, 1992), and testosterone enanthate 200 mg every 2 weeks for 3 months led to increased osteocalcin compared with untreated controls (Morley et al, 1993). Testosterone replacement has been associated with increased haematocrit (Tenover, 1992;Morley et al, 1993) which may be beneficial but rarely may also lead to problems with polycythaemia. The effect on lipids is probably minor, with reduction in cholesterol and low density lipoprotein (LDL), and a decline or no change in high density lipoprotein (HDL) (Tenover, 1992;Morley et al, 1993).…”

Section: Ageingmentioning

confidence: 99%

“…Testosterone replacement has been associated with increased haematocrit (Tenover, 1992;Morley et al, 1993) which may be beneficial but rarely may also lead to problems with polycythaemia. The effect on lipids is probably minor, with reduction in cholesterol and low density lipoprotein (LDL), and a decline or no change in high density lipoprotein (HDL) (Tenover, 1992;Morley et al, 1993). The resulting effects on the cardiovascular system have not been firmly established.…”

Section: Ageingmentioning

confidence: 99%