Exercise improves the effects of testosterone replacement therapy and the durability of response after cessation of treatment: a pilot randomized controlled trial

Abstract

The effects of the combination of exercise and TRT on symptoms of late-onset hypogonadism (LOH) and the durability of response after cessation of TRT were investigated. A total of fifty patients with erectile dysfunction (ED) who had a sedentary lifestyle and low serum total testosterone (T) levels were enrolled and followed for 20 weeks. Patients were randomly divided into two groups; all of them received T gel for 12 weeks and it was discontinued for 8 weeks. Patients assigned to Group II were offered a supervised exercise program for 20 weeks. Measurement of serological testing was performed and self-assessment questionnaires and Global Assessment Question (GAQ) were asked. Baseline characteristics and the initial symptom scores showed no significant difference between the two groups. Serum total T levels and the symptom scores were increased at 12 weeks in both groups, and Group II showed better results with statistical significance. There was a decrease in T levels and worsening of symptom scores at week 20 compared to week 12 in both groups, and Group II showed better results with statistical significance. On the GAQ, Group II showed higher ratio of “yes” at week 12 and the same tendency was sustained at week 20 with significant difference between two groups. The combination of exercise and TRT showed significant improvements in serum T levels and LOH symptoms compared to TRT alone. In addition, these improvements were maintained in the combination group with continuous exercise, even after cessation of TRT.

Which Exercise Is Better for Increasing Serum Testosterone Levels in Patients with Erectile Dysfunction?

“…Serum testosterone was significantly improved after 52 weeks of supervised exercise without testosterone treatment. In a recent study, we developed an exercise program consisting of aerobic exercise, whole-body stretching, and resistive strength exercises [ 1 ], and determined that the exercise group with testosterone treatment had significantly higher serum testosterone levels compared to those in the control group. Furthermore, the increased serum testosterone levels were relatively well maintained in the group that continued to perform the exercises after cessation of the testosterone treatment.…”

“…Furthermore, the increased serum testosterone levels were relatively well maintained in the group that continued to perform the exercises after cessation of the testosterone treatment. Regular exercise that significantly reduces BMI, induces an elevation in serum testosterone levels via the following mechanism: the serum insulin level [ 8 ], oxidative stress [ 9 10 ], and conversion of testosterone to estradiol by aromatase in adipose tissue are reduced [ 11 ], and the muscular and plasma dihydrotestosterone concentrations are directly increased [ 1 12 13 ].…”

“…In a recent publication [ 1 ], we demonstrated that exercise improves the efficacy of testosterone treatment for patients with testosterone deficiency (TD), and prolongs the duration of the treatment effect after treatment cessation. In that study, we administered an exercise program that included 20 minutes of aerobic exercise followed by 10 minutes of whole-body stretching, 30 minutes of strength exercise, and 10 minutes of aerobic exercise.…”

Erectile dysfunction treatment and traditional medicine—can East and West medicine coexist?

“…Low levels of physical exercise can be associated with ejaculatory and erectile disorders. And higher levels of physical exercise have been shown to improve erectile function in hypogonadal men undergoing testosterone replacement therapy ( 51 ). There are however, no proven physical exercises that can improve erections directly.…”

Predictive Factors of Efficacy Maintenance after Testosterone Treatment Cessation

“…However, there is no conclusive evidence as to whether patients with TD who benefit from TRT must continue the treatment for the rest of their lives. In some patients, the effect of TRT does not persist after treatment cessation, provoking a return to baseline [7,8]. In contrast, some patients show no significant TD symptoms, with normal TT levels, after TRT cessation.…”