State-of-the-Art: a Review of Cardiovascular Effects of Testosterone Replacement Therapy in Adult Males

Elsherbiny, Ahmed; Tricomi, Matthew; Bhatt, Digant; Dandapantula, Hari Kumar

doi:10.1007/s11886-017-0838-x

Cited by 19 publications

(18 citation statements)

References 43 publications

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“…In fact, a 4‐fold increase in TRT has been observed in younger men (ages 18‐45) since 2003 13 . Although the long‐term benefits and risks associated with TRT have not been established and continue to be debated, 14 a few retrospective studies have associated TRT with increased risk of cardiovascular events 15 . Erythrocytosis and polycythemia secondary to TRT are common side effects of testosterone administration to patients, 16,17 who often present at blood centers for therapeutic phlebotomy.…”

Section: Introductionmentioning

confidence: 99%

“…13 Although the long-term benefits and risks associated with TRT have not been established and continue to be debated, 14 a few retrospective studies have associated TRT with increased risk of cardiovascular events. 15 Erythrocytosis and polycythemia secondary to TRT are common side effects of testosterone administration to patients, 16,17 who often present at blood centers for therapeutic phlebotomy. In 2018, the US Food and Drug Administration allowed RBC components derived from therapeutic phlebotomies by blood donors who receive TRT to be used for allogeneic transfusion.…”

Section: Introductionmentioning

confidence: 99%

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Testosterone replacement therapy in blood donors modulates erythrocyte metabolism and susceptibility to hemolysis in cold storage

et al. 2020

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Background: Red blood cells (RBCs) derived from patients who receive testosterone replacement therapy (TRT) may be considered eligible for component production and transfusion. The aim of this study was to identify testosteronedependent changes in RBC metabolism and to evaluate its impact on susceptibility to hemolysis during cold storage. Study Design and Methods: We characterized stored RBCs from two cohorts of TRT patients who were matched with control donors (no TRT) based upon sex, age, and ethnicity. We further evaluated the impact of testosterone deficiency (orchiectomy) on RBC metabolism in FVB/NJ mice. RBC metabolites were quantified by ultra-high-pressure liquid chromatography-mass spectrometry. RBC storage stability was determined in RBC units from TRT and controls by quantifying storage, osmotic, and oxidative hemolysis. Results: Orchiectomy in mice was associated with significant (P < 0.05) changes in RBC metabolism as compared with intact males including increased levels of acyl-carnitines, long-chain fatty acids (eg, docosapentaenoic acids), arginine, and dopamine. Stored RBCs from TRT patients exhibited higher levels of pentose phosphate pathway metabolites, glutathione, and oxidized purines (eg, hypoxanthine), suggestive of increased activation of antioxidant pathways in this group. Further analyses indicated significant changes in free fatty acids and acyl-carnitines in response to testosterone therapies. With regard to hemolysis, TRT was associated with enhanced susceptibility to osmotic hemolysis. Correlation analyses identified acyl-carnitines as significant modifiers of RBC predisposition to osmotic and oxidative hemolysis. Conclusions: These observations provide new insights into testosteronemediated changes in RBC metabolome and biology that may impact the storage capacity and posttransfusion efficacy of RBCs from TRT donors.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Testosterone replacement therapy in blood donors modulates erythrocyte metabolism and susceptibility to hemolysis in cold storage

et al. 2020

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“…Nevertheless, our results clearly show that male infertility must be considered as a serious side effect of TRT. Use of TRT by men with hypogonadal symptoms is generally safe, but numerous reports have documented other adverse effects of TRT, such as cardiovascular disease, prostate cancer, obstructive sleep apnea, and erythrocytosis [18-20]. However, only a few recent studies have documented the deleterious effect of TRT on male fertility [6,7].…”

Section: Discussionmentioning

confidence: 99%

Misuse of testosterone replacement therapy in men in infertile couples and its influence on infertility treatment

Song

Sung

Her

et al. 2019

Clin Exp Reprod Med

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Objective:We investigated the clinical characteristics of men with testosterone replacement therapy (TRT)-induced hypogonadism and its effect on assisted reproductive technology (ART) in infertile couples. Methods: This study examined the records of 20 consecutive male patients diagnosed with azoospermia or severe oligozoospermia (<5×10 6 /mL) who visited a single infertility center from January 2008 to July 2018. All patients were treated at a primary clinic for erectile dysfunction or androgen deficiency symptoms combined with low serum testosterone. All men received a phosphodiesterase 5 inhibitor and TRT with testosterone undecanoate (Nebido®) or testosterone enanthate (Jenasteron®). Patients older than 50 years or with a chronic medical disease such as diabetes were excluded. Results: The mean age of patients was 37 years and the mean duration of infertility was 16.3 ± 11.6 months. At the initial presentation, eight patients had azoospermia, nine had cryptozoospermia, and three had severe oligozoospermia. Serum follicle-stimulating hormone levels were below 1.0 mIU/mL in most patients. Three ongoing ART programs with female factor infertility were cancelled due to male spermatogenic dysfunction; two of these men had normal semen parameters in the previous cycle. After withholding TRT, serum hormone levels and sperm concentrations returned to normal range after a median duration of 8 months. Conclusion: TRT with high-dose testosterone can cause spermatogenic dysfunction due to suppression of the hypothalamic-pituitary-testicular axis, with adverse effects on infertility treatment programs. TRT is therefore contraindicated for infertile couples attempting to conceive, and the patient's desire for fertility must be considered before initiation of TRT in a hypogonadal man. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…The most important sex hormones are testosterone and estrogen which play a key role in the emergence of male and female sex characteristics [2].Testosterone is regulated in the thyroid and exists in both males and females but due to its levels being 50 times higher in males, it has been dubbed the "male sex hormone". This hormone is responsible for secondary sex characteristics in men and measuring its concentration can be helpful in evaluating the health of the gonads [3].…”

Section: Introductionmentioning

confidence: 99%

Effect of Occupational Exposure to Whole-Body Vibration and Noise on Sex Hormone Levels: A Case Study in an Automobile Parts Manufacturing Plant

Mohammadi

Masoud

Dehghan

et al. 2020

Preprint

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Background: The present study investigated the effects of exposure to noise and whole body vibration (WBV) on the levels of sex hormones in an automobile parts manufacturing plant.Methods: The level of workers' exposure (n=162) to each of the mentioned stressors, was measured through standard methods and for each person the time-weighted average (TWA) of exposure was calculated. In order to determine serum sex hormones (free testosterone, LH and FSH), blood samples were taken from all participants after 8-10 hours of fasting between 7-9 am and then the blood samples were analyzed by ELISA method. Results: In general, regarding testosterone as the main male sex hormone, only 49% of the participants were in the normal range. In total of three sections, the lowest mean testosterone levels was observed in the third exposure group (WBV>1.93 m/s2; noise >92.69 dB) of the studied stressor, however, only the difference in testosterone levels between the three different groups of exposure to noise was statistically significant (P = 0.001). The relationship between demographic variables and levels of noise and WBV exposure with sex hormones was not linear and only the relationship between noise exposure and testosterone levels was statistically significant (R = -0.201, P = 0.013). Conclusion: According to the results of Logistic Regression, the WBV had the greatest effect on testosterone levels as the main male hormone. However, according to the results of the correlation test, only the relationship between noise exposure and testosterone levels is statistically significant.

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State-of-the-Art: a Review of Cardiovascular Effects of Testosterone Replacement Therapy in Adult Males

Cited by 19 publications

References 43 publications

Testosterone replacement therapy in blood donors modulates erythrocyte metabolism and susceptibility to hemolysis in cold storage

Testosterone replacement therapy in blood donors modulates erythrocyte metabolism and susceptibility to hemolysis in cold storage

Misuse of testosterone replacement therapy in men in infertile couples and its influence on infertility treatment

Effect of Occupational Exposure to Whole-Body Vibration and Noise on Sex Hormone Levels: A Case Study in an Automobile Parts Manufacturing Plant

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