Plasma levels of dihydrotestosterone remain in the normal range in men treated with long-acting parenteral testosterone undecanoate

Abstract

The major goal of androgen therapy is to achieve testosterone levels as close to physiological concentrations as possible. For some androgen-dependent functions, testosterone is a pro-hormone, peripherally converted to 5 alpha-dihydrotestosterone (DHT) and 17beta-oestradiol of which the levels preferably should also be within their normal physiological ranges. In this study, the resulting plasma DHT levels in 122 hypogonadal men treated with a novel testosterone treatment modality: parenteral long-acting testosterone undecanoate (Nebido), were investigated. Following the treatment, there were no abnormally high/low plasma DHT levels; levels varied between 86 and 511 ng l(-1) (normal range: 40-575 ng l(-1)). In conclusion, treatment with testosterone undecanoate generates physiological levels of DHT. Prostate safety parameters did not undergo changes.

Concerns About Serum Androgens Monitoring During Testosterone Replacement Treatments in Hypogonadal Male Athletes: A Pilot Study

“…As already reported [2], when necessary (e.g., difficulty in dose tailoring with testosterone esters or gel) and/or possible (e.g., drugs and/or money availability, and so forth), the best way to generate a more physiological and long‐life stable androgens profile (e.g., normal serum TT and DHT) may be to start TRT with newer testosterone preparations (e.g., parenteral testosterone undecanoate, subdermal testosterone implants) [43–45] or delivery systems (e.g., devices releasing variable amounts of testosterone), particularly when individualized dose titration are necessary.…”

Late-onset hypogonadism or ADAM: treatment

“…55,56 In relation to TUD, in order to achieve adequate serum levels, the second injection should be given after 6 to 10 weeks, with the interval subsequently extended up to 10-14 weeks (B). 57 It is recommended to apply the second injection after 6 weeks and then one injection every 12 weeks (B) 15,58,59 (C). 16 It is usually well tolerated and changes in the actions and side effects are more frequently observed in obese patients (B).…”

“…There are two formulations of long acting testosterone undecanoate, one presented in 750 mg vials, available in the US, and another with 1000 mg vials, available in Europe and South America. Both are well tolerated by patients, are able to maintain physiological and stable levels of serum testosterone and DHT (B) 59 and have similar effectiveness and safety as other injectable forms (B) 58,63 (D). 64 The advantage of TUD is that with only 4-5 injections per year testosterone levels can be maintained at physiological levels (B).…”

ESSM Position Statement “Sexual Wellbeing After Gender Affirming Surgery”

“… 8 Furthermore, for trans individuals who might be undergoing changes in body composition and perception to align these with their gender identity, specific challenges may arise making sexuality a delicate subject to deal with in counselling. 9 Additionally, data on the significance of sex steroids with respect to sexual functioning and satisfaction in cis individuals 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 brings about the notion that Gender Affirming Medical Interventions (GAMI), such as hormone therapy and surgical interventions, might affect sexual functioning in trans individuals.…”