The purpose of the Nebido® publications portal (NPP) is to present testosterone related research, in an easily searchable and navigable interface, to health professionals who search for scientific information on hypogonadism, testosterone replacement therapy and testosterone related health issues.
This study shows a significant association between increased CV risk biomarkers and low T levels. As T levels increased beyond the hypogonadal range in the patient cohort, the proportion of men with increased CV risk marker levels decreased. Increased CV biomarker levels were associated with plasma T levels lower than 250 ng/dL even after adjustment for age and BMI, further supporting an independent relation between low plasma T levels and increased CV risk.
This study adds valuable new information, because it reports CV risk as a function of plasma T levels using a large panel of both standard and high-sensitivity biomarkers.
Testosterone undecanoate produced significant benefit in all domains of sexual function in men with TT levels ≤8 nmol/L. By contrast, only sexual desire improved significantly with TRT in those with mild HG.
The present findings also suggest that therapeutic trials of TRT, especially with testosterone undecanoate, should be of at least 30 weeks duration (7.5 months), not 3 months as suggested by some guidelines.
This study considered aspects of the relationship between sexual desire and EF. Firstly, by comparing proportions (rather than mean scores) of men showing improved sexual desire and EF with those that did not, it showed that TRT is significantly associated with improved sexual desire in a significantly greater proportion of men than placebo after 6 weeks, while corresponding improvement in EF occurs later at 30 weeks. These observations were particularly evident in the Severe HG group.
Secondly, it showed that change in sexual desire was significantly associated with change in EF. This underscores the important role of sexual desire in predicting EF.
The present study confirms the broad and sustained benefits of TRT across major QOL dimensions, including sexual, somatic, and psychological health, which were maintained over 36 months of testosterone treatment. Of note, the most substantial symptom benefit was observed in the somatic symptom domain, which includes seven somatic complaints related to HG, such as excessive sweating, disturbed sleep, and physical weakness. Modest, sustained improvements in lower urinary tract symptoms also were seen in patients on TRT.
The results of this prospective, multinational hypogonadism clinical outcomes registry provide further evidence of consistent and sustained and benefits of TRT in improving long-term QOL and sexual function in a large, diverse cohort of men with hypogonadism. The consistency of these effects across trials and studies, treatment groups, and different outcome measures is robust and compelling. These findings are in accord with outcomes reported in recent randomized controlled trials: Brock G, Heiselman D, Maggi M, et al. Effect of testosterone solution 2% on testosterone concentration, sex drive and energy in hypogonadal men: results of a placebo controlled study. J Urol 2016;195:699-705. Snyder PJ, Bhasin S, Cunningham GR, et al. Effects of testosterone treatment in older men. N Engl J Med 2016; 374:611-624. Cunningham GR, Stephens-Shields AJ, Rosen RC, et al. Testosterone treatment and sexual function in older men with low testosterone levels. J Clin Endocrinol Metab 2016; 101:3096-3104.
The well known, and standardized, Aging Males’ Symptom (AMS) rating scale measures the severity of aging symptoms in men and their impact on QoL. Analysis of pooled AMS data suggest a significant overall improvement in QoL with TTh.
All three subscales within the AMS (somatic, psychological, and sexual) demonstrated a significant improvement with TTh.
The results of this study confirm that TTh improves multiple aspects of sexual function in hypogonadal patients , as measured by the frequently used, validated instrument, the IIEF. The effect of TTh on ED is independent of age and greater in patients with low T levels at baseline and lower in the presence of metabolic derangements, such as diabetes and obesity. The observed mean 2.3-point increase in IIEF-EFD score should be considered clinically meaningful only in patients with mild ED and not in those with more severe forms. Hence, the present data suggests that TTh alone may be a reasonable treatment option in men with milder ED.
Although it has been proposed by the Food and Drugs Administration (FDA) that hypogonadism should only be treated in men with a limited list of underlying conditions, which has been called ‘‘classic hypogonadism’’ , nearly all studies included in this meta-analysis were comprised of populations of men without classic hypogonadism. For example, in the T trial  63% of the participants were obese. The positive results reported here thus indicate that symptomatic testosterone-deficient men benefit from TTh regardless of the underlying etiology.
Orthop J Sports Med. 2017 Aug 9;5(8):2325967117722794. doi: 10.1177/2325967117722794. eCollection 2017 Aug.
The present study demonstrated that young, healthy, eugonadal male patients experienced a significant increase in lean mass 6 weeks after ACL reconstruction with testosterone supplementation of 200 mg/wk compared to a slight decrease in lean mass at the same time point in patients receiving placebo. There were no adverse effects with this testosterone dose observed over the course of this study.
This is the first study investigating the effects of perioperative testosterone supplementation after ACL reconstruction. It is well documented that testosterone treatment increases lean mass in both healthy young men and older hypogonadal men. This study adds to the evidence base by showing that testosterone treatment also increases lean mass after knee surgery.
Most observational studies show that low endogenous testosterone levels are associated with poor cognitive performance in healthy elderly men. Testosterone treatment exerts positive effects on certain cognitive domains in normal and hypogonadal elderly men. Improvements in cognitive function are especially notable in older hypogonadal men with cognitive impairment.
OBSERVATIONAL STUDY CROSS-SECTIONAL (EPIDEMIOLOGY)
J Sex Med. 2017 Dec;14(12):1504-1523.
Testosterone deficiency is a well-established, significant medical condition with defined clinical symptoms and is associated with increased cardiovascular and all-cause mortality. Treatment is effective, evidence based and safe. Recent studies suggest that T Therapy resulting in sustained normalisation of serum levels is probably associated with reduced mortality.
Therapy is associated with multiple benefits maybe highly relevant to the patient but underestimated by specialist physicians focused on specific outcomes. These consensus statements enable physicians to treat patients according to best available scientific evidence.
Asian J Androl. 2017 Dec 1. doi: 10.4103/aja.aja_50_17. [Epub ahead of print]
In large prospective cohort studies of predominantly middle‑aged and older men, lower circulating T predicts higher incidence of cardiovascular events. Both lower circulating T and lower DHT are associated with higher incidence of stroke.
Lower circulating T has been shown to predict higher CVD‑related mortality, as has lower circulating DHT. Thus, epidemiological studies support the utility of lower circulating androgens as a risk predictor for CVD.