The abstracts below show the benefits of testosterone replacement therapy in men with low testosterone levels, or hypogonadism, andropause, or "male menopause" as it is commonly known. All highlights and italics are by Dr. Shira Miller.
A practical guide to male hypogonadism in the primary care setting. Int J Clin Pract. 2010 May;64(6):682-96. Dandona P, Rosenberg MT. Division of Endocrinology, Diabetes and Metabolism, State University of New York at Buffalo and Kaleida Health, Buffalo, NY, USA.
There is a high prevalence of hypogonadism in the older adult male population and the proportion of older men in the population is projected to rise in the future. As hypogonadism increases with age and is significantly associated with various comorbidities such as obesity, type 2 diabetes, hypertension, osteoporosis and metabolic syndrome, the physician is increasingly likely to have to treat hypogonadism in the clinic. The main symptoms of hypogonadism are reduced libido/erectile dysfunction, reduced muscle mass and strength, increased adiposity, osteoporosis/low bone mass, depressed mood and fatigue...Click here to continue reading.
A randomized, double-blind, placebo-controlled study of testosterone treatment in hypogonadal older men with subthreshold depression (dysthymia or minor depression).
J Clin Psychiatry. 2009 Jul;70(7):1009-16. Shores MM, Kivlahan DR, Sadak TI, Li EJ, Matsumoto AM. Geriatric Research, Education, and Clinical Center, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Wash. 98108, USA.
J Clin Psychiatry. 2009 Jul;70(7):1009-16. Shores MM, Kivlahan DR, Sadak TI, Li EJ, Matsumoto AM. Geriatric Research, Education, and Clinical Center, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Wash. 98108, USA.
OBJECTIVE: Hypogonadism and subthreshold depression are common conditions in elderly men. The objective of this study was to examine the effect of testosterone treatment in older, hypogonadal men with subthreshold depression...Click here to continue reading.
Subjective sexual response to testosterone replacement therapy based on initial serum levels of total testosterone.
J Sex Med. 2007 Nov;4(6):1757-62. Reyes-Vallejo L, Lazarou S, Morgentaler A.
J Sex Med. 2007 Nov;4(6):1757-62. Reyes-Vallejo L, Lazarou S, Morgentaler A.
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
INTRODUCTION: Testosterone replacement therapy (TRT) has been shown to be beneficial for men with hypogonadism. However, it is unknown how well hypogonadal men respond to TRT based on the severity of testosterone deficiency. AIM: To determine subjective sexual response rates to TRT based on initial serum testosterone values, with particular interest in men with "low-normal" levels of total testosterone (TT)...Click here to continue reading.
Welcoming low testosterone as a cardiovascular risk factor.
Maggio M, Basaria S. Department of Internal Medicine, Division of Endocrinology & Metabolism, University of Parma, Parma, Italy.
Male hypogonadism now has a new spectrum of complications. They are mainly cardiometabolic in nature. Low serum testosterone levels are a risk factor for diabetes, metabolic syndrome, inflammation and dyslipidemia. These metabolic and inflammatory complications are not without consequences...Click here to continue reading.
Age-related changes in serum testosterone and sex hormone binding globulin in Australian men: longitudinal analyses of two geographically separate regional cohorts. J Clin Endocrinol Metab. 2007 Sep;92(9):3599-603. Liu PY, Beilin J, Meier C, Nguyen TV, Center JR, Leedman PJ, Seibel MJ, Eisman JA, Handelsman DJ.
Department of Andrology, Concord Hospital and ANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, Australia.
BACKGROUND: Cross-sectional studies from different populations show a variable decline in blood testosterone concentrations as men age...Click here to continue reading.
Low serum testosterone and mortality in older men.
J Clin Endocrinol Metab. 2008 Jan;93(1):68-75. Laughlin GA, Barrett-Connor E, Bergstrom J. Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0631C, La Jolla, California 92093, USA.
CONTEXT: Declining testosterone levels in elderly men are thought to underlie many of the symptoms and diseases of aging; however, studies demonstrating associations of low testosterone with clinical outcomes are few. OBJECTIVE: The objective of the study was to examine the association of endogenous testosterone levels with mortality in older community-dwelling men...Click here to continue reading.
Testosterone Replacement Therapy and Prostate Risks: Where’s the Beef? Abraham Morgentaler, MD, Division of Urology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
It has been over 60 years since Huggins published his landmark work showing that castration caused regression of metastatic prostate cancer, linking forever the issues of prostate cancer and testosterone (T).1 The recognition that prostate cancer is largely androgen-dependent has resulted in a reluctance, and in some quarters even a strong antipathy, to treat hypogonadal men with testosterone replacement therapy (TRT). Afterall, castration or pharmacologic lowering of serum T to castrate levels continues to be a mainstay of treatment for advanced prostate cancer to this day. If lowering testosterone makes prostate cancer cells die, then it should follow that raising testosterone should make prostate cancer cells grow.
Nevertheless, there is growing recognition in the medical community that hypogonadism is a significant and treatable condition of men that becomes increasingly common with aging. Moreover, the benefits of TRT have been well documented, including improvement in libido, erectile dysfunction, mood, cognition, lean body mass, and bone density.2 How then does one reconcile the benefits of TRT in the hypogonadal man with the potential risk that TRT may cause an occult cancer to grow?
Curiously, after all these years of testosterone usage and awareness of the androgendependence of prostate cancer, there remains no compelling evidence that TRT does, in fact, represent a true risk for prostate cancer growth...Click here to continue reading.
Association between sleep and morning testosterone levels in older men.
Sleep. 2007 Apr;30(4):427-32. Penev PD. Section of Endocrinology, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA.
STUDY OBJECTIVES:
The circulating testosterone levels of healthy men decline with advancing age. This process is characterized by considerable inter-individual variability, the causes of which are of significant biological and clinical interest but remain poorly understood. Since sleep quantity and quality decrease with age, and experimentally-induced sleep loss in young adults results in hormonal changes similar to those that occur spontaneously in the course of aging, this study examined whether some of the variability in circulating testosterone levels of older men can be related to objective differences in their sleep...Click here to continue reading.
Effect of 1 Week of Sleep Restriction on Testosterone Levels in Young Healthy Men. JAMA. 2011 Jun 1;305(21):2173-4. Rachel Leproult, PhD; Eve Van Cauter, PhD, Department of Medicine, University of Chicago, Chicago, Illinois, USA. Research Letter
To the Editor: Chronic sleep curtailment is endemic in modern societies. The majority of the daily testosterone release in men occurs during sleep. 1 Sleep fragmentation and obstructive sleep apnea are associated with reduced testosterone levels. 2 In older men, morning testosterone levels are partly predicted by total sleep time. 3 Testosterone is critical in male sexual behavior and reproduction, but also has important beneficial effects on muscle mass and strength, adiposity, bone density, and vigor and well-being. 4 We investigated the effect of 1 week of sleep restriction on testosterone levels in young healthy men...Click here to continue reading.
A population-level decline in serum testosterone levels in American men.
J Clin Endocrinol Metab. 2007 Jan;92(1):196-202. Travison TG, Araujo AB, O'Donnell AB, Kupelian V, McKinlay JB.
New England Research Institutes, 9 Galen Street, Watertown, Massachusetts 02472, USA.
CONTEXT: Age-specific estimates of mean testosterone (T) concentrations appear to vary by year of observation and by birth cohort, and estimates of longitudinal declines in T typically outstrip cross-sectional decreases. These observations motivate a hypothesis of a population-level decrease in T over calendar time, independent of chronological aging...Click here to continue reading.
Categories
- Testosterone levels now lower than ever
- Symptoms of low testosterone (hypogonadism)
- Low testosterone and mild depression
- Testosterone replacement improves sexual function
- Low testosterone is a cardiovascular risk factor
- Low testosterone increases risk of death
- Men's testosterone levels decrease by about 1% each year
- Does testosterone cause prostate cancer?
- Total sleep time predicts testosterone levels in older men
- Sleep restriction reduces testosterone levels in young men
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