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Hypogonadal Men (hypogonadal + man)
Selected AbstractsSexual functions of men with obstructive sleep apnoea syndrome and hypogonadism may improve upon testosterone administration: a pilot studyANDROLOGIA, Issue 3 2009V. N. Zhuravlev Summary This study examined 72 patients with obstructive sleep apnoea syndrome (OSAS), confirmed by polysomnography. Thirty-two patients were suffering from erectile dysfunction (ED) assessed by IIEF-5 questionnaires and confirmed by nocturnal penile tumescence examination. Their testosterone levels were measured. Eight patients had normal testosterone levels and were treated with a PDE-5 inhibitor (vardenafil) only; after 6 months of treatment, 6 of these patients (75%) showed significant improvement in erectile function. The remaining 24 patients with OSAS, ED and hypogonadism (total testosterone <12 nmol l,1), were divided into two groups based on the indication for continuous positive airway pressure (CPAP) therapy: five patients received CPAP therapy (group 1) and 19 patients did not (group 2). The patients of group 2 received only a PDE-5 inhibitor (vardenafil 20 mg) for ED; and eight patients (42%) showed an improvement after 3 months of treatment. The five patients receiving CPAP therapy were treated with a combination of parenteral testosterone undecanoate and a PDE-5 inhibitor (vardenafil) and all had normal erectile function after 3 months of therapy. The results suggest positive effects of addition of testosterone to treatment with PDE-5 inhibitors in hypogonadal men with OSAS, which should be confirmed in larger controlled studies. [source] Concurrent improvement of the metabolic syndrome and lower urinary tract symptoms upon normalisation of plasma testosterone levels in hypogonadal elderly menANDROLOGIA, Issue 1 2009A. Haider Summary Central obesity in adulthood, the metabolic syndrome, erectile failure and lower urinary tract symptoms (LUTS) are all associated with lower-than-normal testosterone levels, although the relationship between testosterone and LUTS appears weak. The metabolic syndrome is associated with an overactivity of the autonomic nervous system. Alternatively, the metabolic syndrome is associated with markers of inflammation, such as C-reactive protein (CRP), maybe signalling intraprostatic inflammation. A large cohort of 95 middle-aged to elderly hypogonadal men (T levels 5.9,12.1 nmol l,1) were treated with parenteral testosterone undecanoate and its effects on the metabolic syndrome {waist circumference, cholesterol, CRP and LUTS [residual bladder volume (RBV), International Prostate Symptoms Score (IPSS), prostate volume, prostate-specific antigen (PSA)]} were evaluated. Along with the improvements of the metabolic syndrome, there was a significant decline of the values of the IPSS, RBV and CRP. There was a (low) level of correlation between the decline of waist circumference and residual volume of urine but not with IPSS and prostate size. Along with the improvement of the metabolic syndrome upon testosterone administration, there was also an improvement of the IPSS and of RBV of urine and CRP. The mechanism remains to be elucidated. [source] Plasma levels of dihydrotestosterone remain in the normal range in men treated with long-acting parenteral testosterone undecanoateANDROLOGIA, Issue 5 2007A. A. Yassin Summary 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,-dihydrotestosterone (DHT) and 17,-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 (NebidoŽ), 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. [source] A novel testosterone gel formulation normalizes androgen levels in hypogonadal men, with improvements in body composition and sexual functionBJU INTERNATIONAL, Issue 4 2003A.R.E. Blacklock, FRCS Ed No abstract is available for this article. [source] Serum testosterone and bioavailable testosterone correlate with age and body size in hypogonadal men treated with testosterone undecanoate (1000 mg IM , NebidoŽ)CLINICAL ENDOCRINOLOGY, Issue 4 2008Robert Moisey Summary Objective, To investigate the loading regimen for intramuscular (IM) testosterone undecanoate (NebidoŽ) to determine whether testosterone and bioavailable testosterone levels achieved correlate with age or body size of subjects studied. Design, Retrospective observational study of testosterone naīve patients and patients previously treated with an alternative testosterone therapy. Patients, 51 hypogonadal men (35, 68ˇ6% secondary hypogonadism). 8 (16%) had not previously received testosterone therapy. Measurements, Patients received an IM injection of Nebido (1000 mg) at baseline and a second injection after 6 weeks. Serum was assayed at baseline and 18 weeks after commencing Nebido for total testosterone (TT) and SHBG. Bioavailable testosterone was calculated (cBioT) using TT and SHBG. Measurements were taken for weight, body mass index (BMI) and body surface area (BSA). Results, Baseline TT (mean 11ˇ5 nmol/l, range 0ˇ3,54ˇ8) increased by 50% after commencing Nebido (17ˇ2 nmol/l (5ˇ4,32ˇ8), P = 0ˇ0001). 75% of subjects had a TT within the reference range (8ˇ0,25ˇ0 nmol/l). Subjects with primary hypogonadism had a higher 18-week TT [20ˇ9 nmol/l (9ˇ8,32ˇ8) vs. 15ˇ5 (5ˇ4,32ˇ6), P = 0ˇ02] and SHBG [39ˇ2 nmol/l (11,82) vs. 25ˇ7 (9ˇ0,60ˇ0), P = 0ˇ003] although the cBioT was not significantly different [4ˇ9 nmol/l (2ˇ9,7ˇ3) vs. 4ˇ2 (2ˇ0,7ˇ9), P = 0ˇ12]. The 18-week TT positively correlated with age (R = 0ˇ36, P = 0ˇ01) and negatively correlated with weight (R = ,0ˇ38, P = 0ˇ006), BMI (R = ,0ˇ42, P = 0ˇ002) and BSA (R =,0ˇ38, P = 0ˇ007). Similarly cBioT correlated with age (R = 0ˇ28, P = 0ˇ04), weight (R = ,0ˇ29, P = 0ˇ03), BMI (R = ,0ˇ30, P = 0ˇ03) and BSA (R = ,0ˇ27, P = 0ˇ05). Age (t = 2ˇ04, P = 0ˇ05) and baseline testosterone (t = ,9ˇ26, P < 0ˇ0001) were independent variables of the increase in TT at 18 weeks. Conclusion, This starting regimen is simple and provides the majority of men with a TT within the reference range. Age and baseline TT are independent variables of the increase in TT with IM testosterone undecanoate. At week 18 age and body size correlated with the cBioT and TT and this may then be used to estimate dosing frequency for this therapy. [source] Testosterone treatment comes of age: new options for hypogonadal menCLINICAL ENDOCRINOLOGY, Issue 3 2006Eberhard Nieschlag Summary Male hypogonadism is one of the most frequent, but also most underdiagnosed, endocrinopathies. However, the required testosterone treatment is simple and very effective if properly administered. Although testosterone has been available for clinical use for seven decades, until quite recently the treatment modalities were far from ideal. Subdermal testosterone pellets require minor surgery for insertion and often cause local problems. The injectable testosterone enanthate, for a long period the most frequently used mode of administration, lasts for two to four weeks, but produces supraphysiological levels initially and low levels before the next injection. The oral testosterone undecanoate has to be taken three times daily, has an uncertain absorption pattern and results in peaks and valleys of serum testosterone levels throughout the day. With the advent of transdermal testosterone preparations, the desired physiological serum levels could be achieved for the first time. Scrotal testosterone patches were the first to fulfil this requirement. These were followed by nonscrotal skin patches, which, however, cause considerable skin reactions including erythema and blisters. Recently introduced, invisible transdermal testosterone gels increased the intervals of application and are now slowly replacing other modalities. A mucoadhesive buccal testosterone tablet with sustained release is also a recent competing modality. Finally, injectable testosterone undecanoate in castor oil was made into a real depot preparation requiring only four injections per year for replacement therapy. These new preparations with a desired pharmacokinetic testosterone profile give the patient a real choice and make treatment easier. Based on pharmacogenetic considerations taking the androgen receptor polymorphism into account, treatment may be individualized for each patient in the future. [source] | ||||||||||