Characteristics of Men Undergoing Testosterone Replacement Therapy and Adherence to Follow-up Recommendations in Metropolitan Multicenter Health Care System

Malik, Rena D.; Wang, Chihsiung E.; Lapin, Brittany; Lakeman, Justin C.; Helfand, Brian T.

doi:10.1016/j.urology.2015.01.027

Cited by 20 publications

(9 citation statements)

References 27 publications

(26 reference statements)

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“…Interestingly, regarding the type of preparation, data showed no improvement in body composition for oral testosterone preparations compared to transdermal and parental preparations. A potential explanation could be related to the different medication adherence which could have further contributed to the differences in effects observed [ 44 ].…”

Section: Clinical Findingsmentioning

confidence: 99%

The Role of Testosterone in the Elderly: What Do We Know?

Barone

Napolitano

Cirillo

et al. 2022

IJMS

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Testosterone is the most important hormone in male health. Aging is characterized by testosterone deficiency due to decreasing testosterone levels associated with low testicular production, genetic factors, adiposity, and illness. Low testosterone levels in men are associated with sexual dysfunction (low sexual desire, erectile dysfunction), reduced skeletal muscle mass and strength, decreased bone mineral density, increased cardiovascular risk and alterations of the glycometabolic profile. Testosterone replacement therapy (TRT) shows several therapeutic effects while maintaining a good safety profile in hypogonadal men. TRT restores normal levels of serum testosterone in men, increasing libido and energy level and producing beneficial effects on bone density, strength and muscle as well as yielding cardioprotective effects. Nevertheless, TRT could be contraindicated in men with untreated prostate cancer, although poor findings are reported in the literature. In addition, different potential side effects, such as polycythemia, cardiac events and obstructive sleep apnea, should be monitored. The aim of our review is to provide an updated background regarding the pros and cons of TRT, evaluating its role and its clinical applicability in different domains.

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Section: Clinical Findingsmentioning

confidence: 99%

The Role of Testosterone in the Elderly: What Do We Know?

Barone

Napolitano

Cirillo

et al. 2022

IJMS

View full text Add to dashboard Cite

show abstract

“…Of men who are treated with testosterone, nearly half do not have their testosterone levels checked after therapy commences. 2,3 While up to a third of men who are placed on testosterone therapy do not meet the criteria to be diagnosed as testosterone deficient, 2,3 This document is being printed as submitted independent of editorial or peer review by the editors of The Journal of UrologyÒ.…”

Section: Introductionmentioning

confidence: 99%

Evaluation and Management of Testosterone Deficiency: AUA Guideline

et al. 2018

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The care of testosterone deficient patients should focus on accurate assessment of total testosterone levels, symptoms, and signs as well as proper on-treatment monitoring to ensure therapeutic testosterone levels are reached and symptoms are ameliorated. Future longitudinal observational studies and clinical trials of significant duration in this space will improve diagnostic techniques and treatment of men with testosterone deficiency as well as provide more data on the adverse events that may be associated with testosterone therapy.

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“…In previous studies, testosterone propionate demonstrated a good therapeutic effect at a dose of 3 mg/kg/day. 9,15,16 Performing ART with a long-term formulation can increase the dosing interval while increasing the dose per injection. As shown in this study, after administration, the concentration of testosterone enanthate in blood was high, which may adversely affect erectile function.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 Malik RD reported that many patients who were receiving testosterone did not fulfill the diagnostic criteria for testosterone deficiency, and the follow-up after testosterone administration is usually inadequate. 15 Some athletes use anabolic-androgenic steroids (AAS). AAS contains testosterone and its synthetic derivatives and is prone to abuse.…”

Section: Introductionmentioning

confidence: 99%

Effect of High Testosterone Levels on Endothelial Function in Aorta and Erectile Function in Rats

et al. 2022

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Background Testosterone is an important hormone for the physical and mental health of men; however testosterone administration has also been suggested to adversely affect the cardiovascular system. Aim To investigate the effects of excessive testosterone administration on vascular endothelial and erectile function in rats. Methods A total of seventy-five 12-week-old rats were divided into the following groups: Sham, castrated (Cast), castrated with subcutaneous administration of 100 mg/kg/month testosterone (Cast + T1), and castrated with subcutaneous administration of 100 mg/kg/week testosterone (Cast + T4). To observe the changes in testosterone level after the administration, rats were further divided into the following groups: control; T(6.25), wherein the rats were subcutaneously injected with 6.25 mg/kg testosterone; T(25) per week, wherein the rats were subcutaneously injected with 25 mg/kg testosterone per week; and T(100), wherein the rats were subcutaneously injected with 100 mg/kg testosterone per week. The relaxation responses of aorta were measured in these rats using standardized methods, and their erectile function was also evaluated. Statistical analysis of the obtained data was performed using two-way analysis of variance (ANOVA), Tukey-Kramer's multiple comparison test, or Student's t-test. Outcomes At the end of the study period, endothelial function was evaluated through measurement of isometric tension, while erectile function was assessed using intracavernosal pressure (ICP), mean arterial pressure (MAP), and the expression of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), sirtuin 1 (Sirt1) and vascular endothelial growth factor A. Results The ICP/MAP ratio in the Cast group (0.42 ± 0.04) was significantly lower than that in the Sham group (0.79 ± 0.07). The ICP/MAP ratio in the Cast + T1 group (0.73 ± 0.06) was significantly higher than that in the Cast group (P < .01) and that of the Cast + T4 (0.38 ± 0.01) group was unchanged (P > .05). The T(25) and T(100) groups exhibited significantly lower responses to ACh than the control group at 4 weeks (P < .01). Meanwhile, the ICP/MAP ratios in the T(25) group (0.44 ± 0.07) and T(100) group (0.47 ± 0.03) were significantly lower than that in the control group (0.67 ± 0.05) at stimulation frequencies of 16 Hz (P < .05). The expression of androgen receptor, Sirt1, and eNOS were significantly lower while that of iNOS was higher in the T(25) group compared with the control group (P < .05). Clinical Translation The results based on this animal model indicate that extremely high testosterone levels may affect endothelial and erectile function. Strengths and Limitations We found that high-dose testosterone administration decreased endothelial function in aorta and erectile function in rats. A major limitation of this study is that the blood concentration may not be representative of that in humans, and further research is needed. Conclusion The findings suggest that high doses of testosterone may cause endothelial dysfunction in the aorta and erectile dysfunction in rats and that the blood concentration should be monitored after testosterone administration.

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Characteristics of Men Undergoing Testosterone Replacement Therapy and Adherence to Follow-up Recommendations in Metropolitan Multicenter Health Care System

Cited by 20 publications

References 27 publications

The Role of Testosterone in the Elderly: What Do We Know?

The Role of Testosterone in the Elderly: What Do We Know?

Evaluation and Management of Testosterone Deficiency: AUA Guideline

Effect of High Testosterone Levels on Endothelial Function in Aorta and Erectile Function in Rats

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