Pharmacology and clinical uses of testosterone

Nieschlag, Eberhard; Behre, Hermann M.

doi:10.1007/978-3-662-00814-0_5

Cited by 32 publications

(43 citation statements)

References 107 publications

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“…The necessity of using ethanol to facilitate absorption through the skin causes a higher rate of skin reactions (65). Hence, while the pharmacokinetic profile fulfills the consensus goal, the inconvenience of having to shave the scrotum occasionally to ensure adhesion of the transcrotal patch prevents some patients from reaping the benefit.…”

Section: Choice Of Testosterone Preparationmentioning

confidence: 99%

Effects of androgen substitution on lipid profile in the adult and aging hypogonadal male

Schleich

Legros

2004

European Journal of Endocrinology

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The decrease in serum bioavailable testosterone may be responsible for the catabolic sequelae noticed in the aging man (decrease in libido, decrease in muscle mass, osteoporosis and increase in adiposity). After a brief review of androgen and lipid metabolism as well as their modifications with aging, we discuss current knowledge of the effects of androgen substitution on the lipid profile in hypogonadal men. The results of studies concerning the effect of androgen substitution therapy on lipids are conflicting but might be favorable. The small decrease in high-density lipoprotein cholesterol observed when administering standard dosages of testosterone is accompanied by a significant decrease in total cholesterol (CT) and low-density lipoprotein cholesterol. A counterbalancing of these effects plausibly accounts for the absence of increase cardiovascular risk. The currently available preparations are oral, injectable or transdermal formulations of natural testosterone. The development of new androgen preparations that are more potent, metabolically stable and tissue-specific will improve therapeutic benefits and reduce side effects. European Journal of Endocrinology 151 415-424

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Section: Choice Of Testosterone Preparationmentioning

confidence: 99%

Effects of androgen substitution on lipid profile in the adult and aging hypogonadal male

Schleich

Legros

2004

European Journal of Endocrinology

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“…5 In addition to having a detrimental effect on erectile activity, hypogonadism brings a diminution in the frequency of sexual thoughts and intercourse. Its adverse effect on the volume of the ejaculate and semen quality are also well recognized.…”

Section: Testosterone and Sexual Functionmentioning

confidence: 99%

Testosterone replacement: when is there a role?

Morales

2000

Int J Impot Res

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Hypogonadism is an uncommon cause of erectile dysfunction. Unfortunately, hypogonadal states in adult males are dif®cult to diagnose on purely clinical grounds and it is necessary to seek biochemical support. The simplest way to establish the diagnosis of hypogonadism is by determination of serum testosterone levels. Several methods exist but total testosterone determination plus assessment of sex hormone-binding globulin or bio-available testosterone appear to be the most reliable and accessible. Once a diagnostic of hypogonadism has been established in a man with erectile dif®culties, a trial of androgen supplementation is warranted if no contraindications exist. Knowledgeable monitoring is essential. In the absence of an adequate response, co-morbidities should be diligently sought out. In the absence of reliable guidelines for androgen administration to patients with erectile failure, a set of recommendations are provided.

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“…Thirty-two hypogonadal men attending the Institute of Reproductive Medicine undergoing effective testosterone replacement therapy (17) and serial measurements of the lumbar spine BMD by QCT were included in the evaluation. Patients with morning serum testosterone below 12 nmol/l and normal to elevated luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels on two different occasions were classified as having primary hypogonadism, and patients with lowered serum testosterone (<12 nmol/l) and lowered basal LH (<1.5 U/l) and FSH (<2 U/l) and without stimulatory response to i.v.…”

Section: Subjects and Treatmentmentioning

confidence: 99%

“…Thirtytwo patients were treated by i.m. injection of testosterone enanthate (250 mg Testoviron Depot; Schering, Berlin, Germany) (17). Seven patients with secondary hypogonadism were switched to human choriogonadotrophin/human menopausal gonadotrophin or GnRH for 1.1Ϯ0.6 years to induce spermatogenesis and paternity (18).…”

Section: Subjects and Treatmentmentioning

confidence: 99%

Effects of testosterone replacement therapy on cortical and trabecular bone mineral density, vertebral body area and paraspinal muscle area in hypogonadal men

Leifke

Korner

Link

et al. 1998

European Journal of Endocrinology

132

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Loss of bone and muscle mass are major findings of male hypogonadism. In order to determine the long-term effect of testosterone replacement therapy on spinal bone and muscles, the trabecular and cortical bone mineral density, vertebral body area and paraspinal muscle area were assessed by quantitative computed tomography in 32 testosterone-substituted patients, aged 18-74 years, with idiopathic hypogonadotropic hypogonadism (n = 6), pituitary insufficiency (n = 5), Klinefelter syndrome (n = 12) or other forms of primary hypogonadism (n = 9). They were followed for a mean period of 3.2Ϯ1.7 years (meanϮS.D.), ranging from 1 to 7 years. A significant correlation between initial serum testosterone levels and bone mineral density was found in patients with congenital forms (r = 0.58; P<0.05) but not in those with acquired forms. A significant increase in trabecular and cortical bone mineral density (P<0.001) was documented in the course of replacement therapy in all patients regardless of the type of hypogonadism and age of patients. A slight but significant increase in paraspinal muscle area was observed if all patients were taken together (P<0.01). The area of paraspinal muscle correlated with body weight (r = 0.58; P<0.001) and moderately with trabecular bone mineral density (r = 0.4; P<0.01). Its increase did not correspond to the change observed for trabecular and cortical bone mineral density. Vertebral body area did not change over time. It correlated only with height and weight but not with bone mineral density. In conclusion, testosterone therapy of hypogonadal men improves both trabecular and cortical bone mineral density of the spine independently of age and type of hypogonadism while vertebral area remains unchanged. The effects seen on paraspinal muscles emphasize the clinical benefit of adequate replacement therapy for the physical fitness of hypogonadal men.

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Pharmacology and clinical uses of testosterone

Cited by 32 publications

References 107 publications

Effects of androgen substitution on lipid profile in the adult and aging hypogonadal male

Effects of androgen substitution on lipid profile in the adult and aging hypogonadal male

Testosterone replacement: when is there a role?

Effects of testosterone replacement therapy on cortical and trabecular bone mineral density, vertebral body area and paraspinal muscle area in hypogonadal men

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