Primary and Secondary Hypogonadism in Male Persons with Diabetes Mellitus

Martins, João Martin; Jorge, Mafalda de Pina; Maia, Catarina; Roque, João; Lemos, Carlos; Nunes, Daniel; Reis, Dinis; Mota, Catarina

doi:10.1155/2021/8799537

Cited by 4 publications

(4 citation statements)

References 43 publications

(52 reference statements)

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“…Only a few studies have investigated the effect of metformin on testosterone concentrations. Observational, case studies and case‐control studies show conflicting results with some studies reporting a negative effect of metformin on total testosterone 29–31 , while others report a beneficial 32 or even no effect 31 . Similarly, both negative and beneficial effects are reported by observational and case (‐controlled) studies on free or bioavailable testosterone 29,31,32 .…”

Section: Resultsmentioning

confidence: 99%

Effects of treatment for diabetes mellitus on testosterone concentrations: A systematic review

et al. 2022

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Background: Low testosterone levels are frequently present in men with obesity and insulin resistance. Currently available treatment options (testosterone replacement therapy or lifestyle changes) hold possible risks or are insufficient. Since low testosterone levels are closely related to obesity and type 2 diabetes, treatment modalities for these conditions could result into improvement of testosterone levels. Objectives:To summarize the available evidence on the effects of traditional and recent treatment modalities for diabetes mellitus on testosterone levels and androgendeficiency-related signs and symptoms. Materials and methods:PubMed was searched from the year 2000 till present using MESH terms: "hypogonadism," "testosterone," "testosterone deficiency," "functional hypogonadism," and the different classes of medications. Studies with observational and experimental designs on humans that evaluated the effect of antidiabetic medications on gonadotropins and testosterone were eligible for inclusion.Results: Current available data show no or only limited improvement on testosterone levels with the classic antidiabetic drugs. Studies with GLP1-receptor analogues show beneficial effects on both body weight and testosterone levels in men with low testosterone levels and obesity with or without type 2 diabetes. However, data are limited to small and heterogeneous study groups and only few studies report data about impact on androgen-deficiency-related signs and symptoms. Discussion and conclusion:With the recent advances in the knowledge of the pathophysiological pathways in obesity, there is an enormous progress in the development of medications for obesity and type 2 diabetes. Newer incretin-based agents have a great potential for the treatment of functional hypogonadism due to obesity since they show promising weight reducing results. However, before the use of GLP1-receptor analogues can be suggested to treat functional hypogonadism, further studies are needed.

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Section: Resultsmentioning

confidence: 99%

Effects of treatment for diabetes mellitus on testosterone concentrations: A systematic review

et al. 2022

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“…Prolonged duration of metformin-based therapy reduces T levels and counteracts the T elevation accompanied by improved blood glucose[ 28 ]. Low T levels have also been observed in patients on metformin, regardless of age, duration of the disease and hemoglobin (HbA1c)[ 29 ]. A recent study indicated that for fathers who took one or more prescriptions for metformin during the development of fertilizing sperm, the likelihood of their male offspring having genital birth defects was increased[ 30 ].…”

Section: Pharmacological Management Of Obesitymentioning

confidence: 99%

Management of male obesity-related secondary hypogonadism: A clinical update

Shenoy,

Mondal,

Fernandez

et al. 2024

World J Exp Med

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The global obesity pandemic has resulted in a rise in the prevalence of male obesity-related secondary hypogonadism (MOSH) with emerging evidence on the role of testosterone therapy. We aim to provide an updated and practical approach towards its management. We did a comprehensive literature search across MEDLINE (via PubMed), Scopus, and Google Scholar databases using the keywords “MOSH” OR “Obesity-related hypogonadism” OR “Testosterone replacement therapy” OR “Selective estrogen receptor modulator” OR “SERM” OR “Guidelines on male hypogonadism” as well as a manual search of references within the articles. A narrative review based on available evidence, recommendations and their practical implications was done. Although weight loss is the ideal therapeutic strategy for patients with MOSH, achievement of significant weight reduction is usually difficult with lifestyle changes alone in real-world practice. Therefore, androgen administration is often necessary in the management of hypogonadism in patients with MOSH which also improves many other comorbidities related to obesity. However, there is conflicting evidence for the appropriate use of testosterone replacement therapy (TRT), and it can also be associated with complications. This evidence-based review updates the available evidence including the very recently published results of the TRAVERSE trial and provides comprehensive clinical practice pearls for the management of patients with MOSH. Before starting testosterone replacement in functional hypogonadism of obesity, it would be desirable to initiate lifestyle modification to ensure weight reduction. TRT should be coupled with the management of other comorbidities related to obesity in MOSH patients. Balancing the risks and benefits of TRT should be considered in every patient before and during long-term management.

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“…Classifying hypogonadism in this way helps doctors choose the most effective course of therapy. Treatment for secondary hypogonadism may potentially restore fertility and normalize testosterone levels, but in primary hypogonadism, only testosterone therapy is an option, and this medication reduces fertility since it suppresses the hypothalamic-pituitary-gonadal (HGP) axis [126,127].…”

Section: Hypogonadotropic Hypogonadismmentioning

confidence: 99%

From Diagnosis to Treatment: Comprehensive Care by Reproductive Urologists in Assisted Reproductive Technology

Kaltsas,

Dimitriadis,

Zachariou

et al. 2023

Medicina

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Infertility is a global health concern, with male factors playing an especially large role. Unfortunately, however, the contributions made by reproductive urologists in managing male infertility under assisted reproductive technology (ART) often go undervalued. This narrative review highlights the important role played by reproductive urologists in diagnosing and treating male infertility as well as any barriers they face when providing services. This manuscript presents a comprehensive review of reproductive urologists’ role in managing male infertility, outlining their expertise in diagnosing and managing male infertility as well as reversible causes and performing surgical techniques such as sperm retrieval. This manuscript investigates the barriers limiting urologist involvement such as limited availability, awareness among healthcare professionals, and financial constraints. This study highlights a decrease in male fertility due to lifestyle factors like sedentary behavior, obesity, and substance abuse. It stresses the significance of conducting an evaluation process involving both male and female partners to identify any underlying factors contributing to infertility and to identify patients who do not require any interventions beyond ART. We conclude that engaging urologists more effectively in infertility management is key to optimizing fertility outcomes among couples undergoing assisted reproductive technology treatments and requires greater education among healthcare providers regarding the role urologists and lifestyle factors that could have an effect on male fertility.

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Primary and Secondary Hypogonadism in Male Persons with Diabetes Mellitus

Cited by 4 publications

References 43 publications

Effects of treatment for diabetes mellitus on testosterone concentrations: A systematic review

Effects of treatment for diabetes mellitus on testosterone concentrations: A systematic review

Management of male obesity-related secondary hypogonadism: A clinical update

From Diagnosis to Treatment: Comprehensive Care by Reproductive Urologists in Assisted Reproductive Technology

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