Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging

Cavallini, Giorgio; Caracciolo, Stefano; Vitali, Giuseppe; Modenini, Fabio; Biagiotti, Giulio

doi:10.1016/j.urology.2003.11.009

Cited by 106 publications

(67 citation statements)

References 20 publications

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“…17 In our study, we have found the Effects are expressed as ORs for the treatment effect on the probability of being in the less-favorable category of the individual items of the ESF questionnaire. a Less than once a week versus once a week or more as reference.…”

Section: Discussionmentioning

confidence: 66%

“…[16][17][18] Moreover, this is the time period that the US Institute of Medicine of the National Academies (IOM) Committee On Assessing The Need For Clinical Trial Of Testosterone Replacement Therapy recommended to be more closely examined in a randomized trial. 19 Compliance is a common problem, especially in hormone substitution trials.…”

Section: Discussionmentioning

confidence: 99%

“…32,33 The testosterone levels in our study were comparable with those in other studies that reported beneficial effects of testosterone supplementation on sexual functioning. 16,17 Moreover, the current available testosterone assays are sub-optimal for the investigation of male reproductive disorders, because of imprecision and inaccuracy of these assays. Also reference ranges will vary because of the differences that exist between methods, and this makes the suggestion of a fixed concentration less helpful.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 A meta-analysis has shown that testosterone use may be associated with small improvements in erectile function and moderate improvement in libido in elderly men. 10,11 However, unexplained inconsistent results across trials, wide confidence intervals and possible reporting bias weaken these inferences.…”

Section: Discussionmentioning

confidence: 99%

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Effect of testosterone supplementation on sexual functioning in aging men: a 6-month randomized controlled trial

et al. 2009

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Serum testosterone levels decline significantly with aging and this has been associated with reduced sexual function. We have conducted a double-blind, randomized, placebo-controlled trial to investigate the effect of testosterone supplementation on sexual function in 237 elderly men with a testosterone level o13.7 nmol l À1 . Participants were randomly assigned to receive oral testosterone undecanoate or a placebo for 6 months. A total of 207 men completed the study. After treatment, there were no differences in scores on sexual function between the groups. Subanalysis showed that although a baseline testosterone level in the lowest tertile was associated with significantly lower scores for sexual fantasies, desire of sexual contact and frequency of sexual contact, supplementation of testosterone did not result in improvement on any of these items in this group. In conclusion, the findings do not support the view that testosterone undecanoate supplementation for 6 months to elderly men with low-normal testosterone concentrations favorably affects sexual function.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of testosterone supplementation on sexual functioning in aging men: a 6-month randomized controlled trial

et al. 2009

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“…Our data are supported by previous studies showing lower testosterone levels among depressed men than in age-matched controls 29 whereas randomized trials failed to find significant effects of testosterone treatment. 30,31 Although men with normal testosterone had more favorable results in 10 of the 12 cognitive function tests and the composite score compared to men with subnormal testosterone, the difference was only significant in one test. Testosterone treatment did not improve cognitive function in agreement with previous studies.…”

Section: Older Men and Testosterone J Svartberg Et Almentioning

confidence: 93%

Testosterone treatment in elderly men with subnormal testosterone levels improves body composition and BMD in the hip

et al. 2008

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Our intention was to examine if subnormal testosterone levels in older men were associated with a reduction in quality of life and physical and mental health, and secondly to examine if testosterone treatment could improve these conditions. We performed a nested case-control study and a 1-year testosterone intervention study. Men with subnormal testosterone had significantly higher weight, fat mass and abdominal adipose tissue. They also had significantly higher glucose and insulin levels, and they had higher triglyceride levels. Testosterone treatment had a large impact on body composition with reduced fat mass and abdominal adipose tissue and increased fat-free mass, but it did not affect weight and glucose and lipid metabolism. Bone mineral density in the hip was significantly higher after the testosterone treatment. Older men with subnormal testosterone levels had an unfavorable metabolic profile. Testosterone treatment improved body composition, but it did not reverse the unfavorable metabolic profile.

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Association of Testosterone Treatment With Alleviation of Depressive Symptoms in Men

2019

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IMPORTANCE Countering depressive disorders is a public health priority. Currently, antidepressants are the first-line treatment, although they show modest effects. In men, testosterone treatment is a controversial alternative or adjunct treatment option. OBJECTIVES To examine the association of testosterone treatment with alleviation of depressive symptoms in men and to clarify moderating effects of testosterone status, depression status, age, treatment duration, and dosage. DATA SOURCES English-language studies published in peer-reviewed journals identified from PubMed/Medline, Embase, Scopus, PsychINFO, and the Cochrane Controlled Trials Register from database inception to March 5, 2018, using the search terms testosterone, mood, administration, dosage, adverse effects, deficiency, standards, therapeutic use, therapy, treatment, and supplementation. STUDY SELECTION Randomized placebo-controlled clinical trials (RCTs) of testosterone treatment that together cover a broad age range and hypogonadal or eugonadal men reporting depressive symptoms on psychometrically validated depression scales. DATA EXTRACTION AND SYNTHESIS Of 7690 identified records, 469 were evaluated against full study inclusion criteria after removing duplicates, reviews, and studies that did not examine male patients or testosterone. Quality assessment and data extraction from the remaining 27 RCTs were performed. MAIN OUTCOMES AND MEASURES Primary outcomes were testosterone treatment effectiveness (standardized score difference after treatment), efficacy (proportion of patients who responded to testosterone treatment with a score reduction of 50% or greater), and acceptability (proportion of patients who withdrew for any reason). RESULTS Random-effects meta-analysis of 27 RCTs including 1890 men suggested that testosterone treatment is associated with a significant reduction in depressive symptoms compared with placebo (Hedges g, 0.21; 95% CI, 0.10-0.32), showing an efficacy of odds ratio (OR), 2.30 (95% CI, 1.30-4.06). There was no significant difference between acceptability of testosterone treatment and placebo (OR, 0.79; 95% CI, 0.61-1.01). Meta-regression models suggested significant interactions for testosterone treatment with dosage and symptom variability at baseline. In the most conservative bias scenario, testosterone treatment remained significant whenever dosages greater than 0.5 g/wk were administered and symptom variability was kept low. CONCLUSIONS AND RELEVANCE Testosterone treatment appears to be effective and efficacious in reducing depressive symptoms in men, particularly when higher-dosage regimens were applied in carefully selected samples. However, given the heterogeneity of the included RCTs, more preregistered trials are needed that explicitly examine depression as the primary end point and consider relevant moderators.

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Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging

Cited by 106 publications

References 20 publications

Effect of testosterone supplementation on sexual functioning in aging men: a 6-month randomized controlled trial

Effect of testosterone supplementation on sexual functioning in aging men: a 6-month randomized controlled trial

Testosterone treatment in elderly men with subnormal testosterone levels improves body composition and BMD in the hip

Association of Testosterone Treatment With Alleviation of Depressive Symptoms in Men

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