Fundamental Concepts Regarding Testosterone Deficiency and Treatment

Abstract

To address widespread concerns regarding the medical condition of testosterone (T) deficiency (TD) (male hypogonadism) and its treatment with T therapy, an international expert consensus conference was convened in Prague, Czech Republic, on October 1, 2015. Experts included a broad range of medical specialties including urology, endocrinology, diabetology, internal medicine, and basic science research. A representative from the European Medicines Agency participated in a nonvoting capacity. Nine resolutions were debated, with unanimous approval: (1) TD is a well-established, clinically significant medical condition that negatively affects male sexuality, reproduction, general health, and quality of life; (2) symptoms and signs of TD occur as a result of low levels of T and may benefit from treatment regardless of whether there is an identified underlying etiology; (3) TD is a global public health concern; (4) T therapy for men with TD is effective, rational, and evidence based; (5) there is no T concentration threshold that reliably distinguishes those who will respond to treatment from those who will not; (6) there is no scientific basis for any age-specific recommendations against the use of T therapy in men; (7) the evidence does not support increased risks of cardiovascular events with T therapy; (8) the evidence does not support increased risk of prostate cancer with T therapy; and (9) the evidence supports a major research initiative to explore possible benefits of T therapy for cardiometabolic disease, including diabetes. These resolutions may be considered points of agreement by a broad range of experts based on the best available scientific evidence.

Testosterone and the Heart

“…In one study, Vigen et al made an official correction for misreporting their primary results, which actually showed a lower percentage of adverse CV events in the T-treated group compared to untreated men. 19 In the other study, Finkle et al had no control group, so it is unknown whether CV events differed between treated and untreated men with TD. 19 The U.S. Food and Drug Administration (FDA) reviewed the CV safety of T products shortly after publication of these articles.…”

“…19 In the other study, Finkle et al had no control group, so it is unknown whether CV events differed between treated and untreated men with TD. 19 The U.S. Food and Drug Administration (FDA) reviewed the CV safety of T products shortly after publication of these articles. In its assessment of CV risks and T therapy, the FDA identified a total of only 4 studies suggesting an increased risk, yet none provided solid evidence to support this.…”

“…By comparison, more than 100 studies have reported reduced CV risk with higher endogenous T concentration, improvement of known CV risk factors with T therapy, and reduced mortality in T-deficient men who underwent TRT versus untreated men. 19 Two recent studies in men who received TRT found reduced CV events in those whose follow-up T level normalized compared to men whose T concentration remained low. 20,21 Another large observational study noted that T therapy was associated with reduced risk of myocardial infarction in men in the highest risk category.…”

New light on an old vitamin: The role of the sunshine vitamin D in chronic disease

“…Adipokines are atherothrombotic risk factors in obese subjects [23]. The last article is written by Gruebler and colleagues who conclude that vitamin D is a strong risk marker for cardiovascular risk factors and disease, similar to what has been reported in men with low testosterone levels [24][25][26][27].…”

Чоловічий Гіпогонадизм (Частина 1)

“…-статеві (зниження лібідо, ерекцій адекватних і спонтанних, статевої активності, статевих фантазій), -фізичні (підвищений ризик обмеження рух-ливості, ламкості кісток і падіння, зниження маси й сили м'язів, підвищення відкладання жирових мас), -психологічні (депресія, роздратованість, со-нливість, порушення когнітивної функції) [21].…”