Testosterone replacement: when is there a role?

Morales, Álvaro

doi:10.1038/sj.ijir.3900588

Cited by 11 publications

(16 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The clinical picture of the ADAM syndrome is characterized by diminished sexual desire and erectile function, decrease in intellectual activity, fatigue, depression, decrease in lean body mass, skin alterations, decrease in body hair, decrease in bone mineral density that results in osteoporosis, and increase in visceral fat and obesity 4 . Testosterone replacement therapy for the hypogonadal aging male is currently under discussion [6][7][8][9][10][11][12][13] . However, since neither the symptoms nor the clinical picture are specific for hormone deficiency, diagnosis requires that blood tests be performed, leading to a heavy impact on health costs.…”

Section: Introductionmentioning

confidence: 99%

Hormone profiles, body mass index and aging male symptoms: results of the Androx Vienna Municipality study

Kratzik

Riedl

et al. 2004

The Aging Male

View full text Add to dashboard Cite

Aging in the male is accompanied by steroid hormonal decline, and men may develop symptoms associated with hypogonadism. Increased awareness of 'andropause' in recent years has led to greater demand for hormonal assessments, resulting in a rising burden for health economics. We conducted a cross-sectional study to define men at risk for hypogonadism, in whom further hormonal investigation should be performed. We examined 664 blue-collar workers aged 40-60 years at their workplace and determined hormonal status and body mass index (BMI). Men with an abnormal urogenital status and those on medication that might affect endocrine status were excluded from the study. All participants completed the validated Aging Male Symptom (AMS) questionnaire and obtained scores for psychological symptoms, somatovegetative symptoms, and sexual symptoms. Multiple logistic regression analyses revealed a significantly increased risk (represented by the odds ratio) of psychological symptoms for men with low levels of testosterone and/or bioavailable testosterone (BAT). Increased BMI as well as low testosterone levels and/or low BAT levels raised the risk of somatovegetative symptoms. Each decrease of BAT by 1 ng/ml caused an approximately 1.8-fold increase of the risk (odds ratio = 1.832, p = 0.005). Additional independent risk factors were increased age and low luteinizing hormone (LH) level. Men aged 55 years with BMI > 28 kg/m2 and with somatovegetative symptoms and moderate or severe psychological symptoms had a 7.2-fold increase in the risk of a BAT level < 1.5 ng/ml compared to men without these risk factors (p < 0.001). Sensitivity and specificity were 75% and 71%, respectively. The AMS score combined with age and BMI provides an easy and convenient method to identify men with probable androgen deficiency who require hormonal assessment.

show abstract

Section: Introductionmentioning

confidence: 99%

Hormone profiles, body mass index and aging male symptoms: results of the Androx Vienna Municipality study

Kratzik

Riedl

et al. 2004

The Aging Male

View full text Add to dashboard Cite

show abstract

“…Although castration results in impotence in most men, some men reported sexual intercourse for up to 20 years after castration [44]. On the other hand, a limited number of hypogonodal men undergo restoration of erection after androgen supplementation [45]. One explanation may be that very small amounts of androgen, such as that made by the adrenal gland, may be sufficient to preserve some erectile function.…”

Section: Human Sexual Function and Testosteronementioning

confidence: 98%

Central nervous system agents in the treatment of erectile dysfunction: How do they work?

Allard

Giuliano

2001

Curr Urol Rep

View full text Add to dashboard Cite

Drugs acting within the central nervous system (CNS) that reduce the sympathetic antierectile flow and enhance the parasympathetic proerectile flow to the penis may restore penile erection in cases of erectile dysfunction of both psychogenic and organic origin. The best characterized of such drugs is the dopaminergic agonist apomorphine, which acts on the hypothalamus and, perhaps, the autonomic nuclei in the spinal cord. Other drugs that target the CNS and have been registered and tested are the a(2)-adrenoceptor antagonists yohimbine and delequamine, the alpha-melanocyte-stimulating hormone agonist melanotan II, and the serotonin reuptake inhibitor trazodone. Androgens also may influence sexual behavior by acting within the CNS, notably by modifying the neurotransmitter system targeted by these drugs. Our knowledge of the mode of action of CNS drugs comes mainly from experiments on rodents. Consequently, explanations regarding the way they work in humans are only speculative.

show abstract

“…Termed 'roller-coaster' effects, these changes are potentially distressing to both hypogonadal patients and their loved-ones. 50 In a 24-week, multicenter, randomized activecomparator trial, the percent of time during the dosing interval that T was within the normal range (PTNR) was significantly lower in men receiving i.m. TE injections (72%) compared with a nonscrotal T patch (82%; P ¼ 0.05).…”

Section: Intramuscular Injections (Im T)mentioning

confidence: 99%

Testosterone replacement therapy for male hypogonadism: Part III. Pharmacologic and clinical profiles, monitoring, safety issues, and potential future agents

Seftel

2005

Int J Impot Res

View full text Add to dashboard Cite

Male hypogonadism is associated with potentially distressing adverse effects on diverse organs and tissues. These include sexual dysfunction, particularly diminished libido, as well as mood disturbances, reduced lean body mass, and increased adipose-tissue mass. A wide range of effective and well-tolerated options exists. These include relatively noninvasive therapies, such as testosterone (T) gels and T patches; slightly more invasive treatments, such as the T buccal system; and invasive therapies, such as intramuscular T injections and subcutaneous depot implants (T pellets). Testosterone replacement therapy (TRT) can be individualized to enhance patient health and well-being. Screening and ongoing monitoring are necessary to ensure both the efficacy and safety of TRT, particularly prostate safety. Investigational agents, including selective androgen receptor modulators, may offer new pharmacodynamic and/or pharmacokinetic properties that enhance outcomes of TRT.

show abstract

Testosterone replacement: when is there a role?

Cited by 11 publications

References 24 publications

Hormone profiles, body mass index and aging male symptoms: results of the Androx Vienna Municipality study

Hormone profiles, body mass index and aging male symptoms: results of the Androx Vienna Municipality study

Central nervous system agents in the treatment of erectile dysfunction: How do they work?

Testosterone replacement therapy for male hypogonadism: Part III. Pharmacologic and clinical profiles, monitoring, safety issues, and potential future agents

Contact Info

Product

Resources

About