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.
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
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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.
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
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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
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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.
Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?
Int J Impot Res. 2003 Jun;15(3):156-65.
Guay AT, Jacobson J, Perez JB, Hodge MB, Velasquez E.
Center for Sexual Function (Endocrinology), Peabody, Massachusetts 01960, USA. firstname.lastname@example.org
Secondary hypogonadism is more common than primary gonadal failure and is seen in chronic and acute illnesses. Although testosterone has a role in erections, its importance in erectile dysfunction (ED) has been controversial. Hypogonadism produced by functional suppression of pituitary gonadotropins has been shown to correct with clomiphene citrate, but with a modest effect on sexual function. We wondered if longer treatment would produce improved results...Click here to continue reading.
Clomiphene citrate and testosterone gel replacement therapy for male hypogonadism: efficacyand treatment cost.
J Sex Med. 2010 Jan;7(1 Pt 1):269-76. Epub 2009 Aug 17.
Taylor F, Levine L.
SourceRush University Medical Center-Department of Urology, Chicago, IL, USA. email@example.com
INTRODUCTION: The efficacy of oral clomiphene citrate (CC) in the treatment of male hypogonadism and male infertility (MI) with low serumtestosterone and normal gonadotropin levels has been reported.
The aim of this article is to evaluate CC and testosterone gel replacement therapy (TGRT) with regard to biochemical and clinical efficacy andcost.
The main outcome measures were change in serum testosterone with CC and TGRT therapy, and change in the androgen deficiency in aging male (ADAM) questionnaire scores with CC therapy.
Men receiving CC or TGRT with either Androgel 1% or Testim 1% for hypogonadism (defined as testosterone < 300 ng/mL) or MI were included. Serum values were collected 1-2 months after treatment initiation and semi-annually thereafter. Retrospective data collection was performed via chart review. Subjective follow up of patients receiving CC was performed via telephone interview using the ADAM questionnaire.
A hundred and four men (65 CC and 39 TGRT) were identified who began CC (50 mg every other day) or TGRT (5 g). Average age (years) was 42(CC) vs. 57 (TGRT)...Click here to continue reading.
Clomiphene citrate is safe and effective for long-term management of hypogonadism.BJU Int. 2012 Mar 28. doi: 10.1111/j.1464-410X.2012.10968.x. [Epub ahead of print]
Moskovic DJ, Katz DJ, Akhavan A, Park K, Mulhall JP.
OBJECTIVE: Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Study Type - Therapy (population cohort) Level of Evidence 2a What's known on the subject? and What does the study add? Clomiphene citrate(CC) has previously been documented to be efficacious in the treatment of hypogonadism. However little is known about the long term efficacy and safety of CC. Our study demonstrates that CC is efficacious after 3 years of therapy. Testosterone levels and bone mineral density measurement improved significantly and were sustained over this prolonged period. Subjective improvements were also demonstrated. No adverse events were reported.
• To assess the efficacy and safety of long-term clomiphene citrate (CC) therapy in symptomatic patients with hypogonadism (HG)...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
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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?