Current Status of Testosterone Replacement Therapy in Men

Winters, Stephen J.

doi:10.1001/archfami.8.3.257

Cited by 83 publications

(11 citation statements)

References 40 publications

(49 reference statements)

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“…17,18 The mechanisms that mediate testosterone's skeletal effects remain incompletely understood. However, in our study, we found no correlation between admission testosterone levels and bone density despite the fact that the older males had lower admission testosterone levels and more bone loss than the younger males.…”

Section: Discussionmentioning

confidence: 99%

High risk of osteoporosis in male patients with eating disorders

Mehler

Sabel

Watson

et al. 2008

Intl J Eating Disorders

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Objective: Osteoporosis has traditionally been considered a female problem. This study's purpose is to evaluate bone mineral density (BMD) in males with eating disorders.Method: Charts of 70 consecutive males admitted to an eating disorder program were reviewed. Females admitted during the same time period were used for comparison. BMD was measured by dual-energy X-ray absorptiometry.Results: Thirty-six percent (19/53) had osteopenia and 26% (14/53) had osteoporosis at the lumbar spine. A disproportionate number of males with anorexia restricting or binge/purge subtype (ANR/ ANB) had osteoporosis, as well as those of older age, lower weights, and longer illness duration. BMD for ANR and ANB males was significantly lower than females (p 5 .02 and p 5 .03, respectively). In multivariate stepwise linear and logistic regression, lowest BMI and illness duration predicted lumbar Zscores. Conclusion:Males with ANR/ANB often have severe bone disease, which is worse than females, and is best predicted by a patient's lowest BMI and illness duration.

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Section: Discussionmentioning

confidence: 99%

High risk of osteoporosis in male patients with eating disorders

Mehler

Sabel

Watson

et al. 2008

Intl J Eating Disorders

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“…The clinical manifestations of androgen deficiency in men may include decreased muscle mass and strength, increased fat mass, decreased hematocrit, decreased libido, erectile dysfunction, infertility, osteoporosis, anxiety, irritability, insomnia, depressed mood. Androgen replacement therapy with testosterone has been proposed to be a safe and effective treatment for testosterone deficiency (Sternbach, 1998;Winters, 1999). However, there are only a limited number of testosterone replacement studies with sometimes conflicting results (Sih et al, 1997;Tenover, 1992;Snyder et al, 1999a,b).…”

Section: Hormone Replacement Therapy In Humansmentioning

confidence: 99%

Steroid hormones and neurosteroids in normal and pathological aging of the nervous system

Schumacher

Weill-Engerer

Lière

et al. 2003

Progress in Neurobiology

269

171

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Without medical progress, dementing diseases such as Alzheimer's disease will become one of the main causes of disability. Preventing or delaying them has thus become a real challenge for biomedical research. Steroids offer interesting therapeutical opportunities for promoting successful aging because of their pleiotropic effects in the nervous system: they regulate main neurotransmitter systems, promote the viability of neurons, play an important role in myelination and influence cognitive processes, in particular learning and memory. Preclinical research has provided evidence that the normally aging nervous system maintains some capacity for regeneration and that age-dependent changes in the nervous system and cognitive dysfunctions can be reversed to some extent by the administration of steroids. The aging nervous system also remains sensitive to the neuroprotective effects of steroids. In contrast to the large number of studies documenting beneficial effects of steroids on the nervous system in young and aged animals, the results from hormone replacement studies in the elderly are so far not conclusive. There is also little information concerning changes of steroid levels in the aging human brain. As steroids present in nervous tissues originate from the endocrine glands (steroid hormones) and from local synthesis (neurosteroids), changes in blood levels of steroids with age do not necessarily reflect changes in their brain levels. There is indeed strong evidence that neurosteroids are also synthesized in human brain and peripheral nerves. The development of a very sensitive and precise method for the analysis of steroids by gas chromatography/mass spectrometry (GC/MS) offers new possibilities for the study of neurosteroids. The concentrations of a range of neurosteroids have recently been measured in various brain regions of aged Alzheimer's disease patients and aged non-demented controls by GC/MS, providing reference values. In Alzheimer's patients, there was a general trend toward lower levels of neurosteroids in different brain regions, and neurosteroid levels were negatively correlated with two biochemical markers of Alzheimer's disease, the phosphorylated tau protein and the ␤-amyloid peptides. The metabolism of dehydroepiandrosterone has also been analyzed for the first time in the aging brain from Alzheimer patients and non-demented controls. The conversion of dehydroepiandrosterone to 5-androstene-3␤,17␤-diol and to 7␣-OH-dehydroepiandrosterone occurred in frontal cortex, hippocampus, amygdala, cerebellum and striatum of both Alzheimer's patients and controls. The formation of these metabolites within distinct brain regions negatively correlated with the density of ␤-amyloid deposits.

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“…1 Testosterone levels decline gradually with age, and testosterone deficiency can cause significant morbidity and substantial reduction in quality of life.…”

Section: Introductionmentioning

confidence: 99%

Effect of testosterone undecanoate on hematological profiles, blood lipid and viscosity and plasma testosterone level in castrated rabbits

Zhao

Moon

Park

2013

CUAJ

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Objective: The association between testosterone replacement therapy and cardiovascular risk remains controversial. Blood viscosity is a known individual risk factor for cardiovascular disease mortality. The objective of the present study was to investigate the effects of the long-acting injectable testosterone undecanoate (TU) on risk factors of cardiovascular disease. Methods: In total, 24 male New Zealand white rabbits (2.5 kg) were randomly divided into 3 groups of 8. Group 1 was used as control. Group 2 was castrated bilaterally and Group 3 was administrated with 6 mg/kg of TU at day 1 and 6 weeks after castration. Whole blood viscosity, total plasma testosterone, hemoglobin (Hb), hematocrit (Hct), fibrinogen (FBN), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were measured at baseline, 6 weeks and 18 weeks. Results: In the control group, whole blood viscosity and FBN were significantly increased at 6 and 18 weeks. Castration significantly increased the levels of TC, TG, HDL-C and LDL-C, but decreased Hct and Hb. In the TU injection group, whole blood viscosity was markedly decreased in all share rates, whereas the FBN level was increased. Hb and Hct showed a tendency for higher concentration at 6 weeks. Conclusions: Long-acting injectable TU provides another reliable treatment option for testosterone replacement therapy. Moreover, the patients may receive additional beneficial effect in lowered whole blood viscosity. IntroductionTestosterone plays a crucial role in the proper development of male reproductive tissues and in the maintenance of male characteristics.1 Testosterone levels decline gradually with age, and testosterone deficiency can cause significant morbidity and substantial reduction in quality of life.Male hypogonadism, affecting about 30% of men between the ages of 40 and 79 years, 2 is a clinical condition in which abnormally low serum testosterone levels are found associated with typical symptoms, including diminished libido and sense of vitality, erectile dysfunction, reduced muscle mass and bone density, depression and anemia.3 Although many of these symptoms can be relieved by restoring serum testosterone levels to the normal range, there is considerable controversy about the potential risks of testosterone replacement therapy.An increasing incidence of hematopoietic disorders is a risk of testosterone use. Testosterone increases erythropoietin production by hypertrophy of renal tissue, particularly in high doses. 4 Activation of androgen receptors in erythroid cells appears to be necessary for testosterone to develop an erythropoietic effect in the bone marrow.5 Drastic elevations of hematocrit (Hct) may be detrimental to patients with underlying coronary, cerebral or peripheral vascular disease by possibly causing an increase in blood viscosity and increased risk of thrombosis.6-8 However, no causal relation has been found between higher testosterone levels and cardiovascular diseas...

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Current Status of Testosterone Replacement Therapy in Men

Cited by 83 publications

References 40 publications

High risk of osteoporosis in male patients with eating disorders

High risk of osteoporosis in male patients with eating disorders

Steroid hormones and neurosteroids in normal and pathological aging of the nervous system

Effect of testosterone undecanoate on hematological profiles, blood lipid and viscosity and plasma testosterone level in castrated rabbits

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