Clinical efficacy of intramuscular versus oral testosterone undecanoate in adult men with hypogonadotropic hypogonadism
Monica Livia Gheorghiu1, Corin Badiu1, Andra Caragheorgheopol2, Mihaela Giurcaneanu2 & Mihai Coculescu1
Aim: To evaluate the clinical efficacy of androgen replacement therapy with oral or intramuscular (i.m.) testosterone undecanoate (T.U.) in male patients with central hypogonadism.
Patients and methods: We retrospectively evaluated 40 patients with hypogonadotropic hypogonadism: 29 with pituitary tumors or craniopharyn-giomas, 11 with non-tumoral hypogonadism (median age 47 years, range 2062), before and after androgen replacement therapy, with the approval of the local Ethical Committee. We evaluated the sexual dysfunction (as declared by the patient), serum testosterone, haemoglobin, hematocrit, cholesterol, triglycerides (measured with commercial kits in venous blood sampled at 8.009.00 am).
Results: In 28 patients treated with oral T.U. (median dose 120 mg/day in 3 doses) for 624 months, the morning serum testosterone raised from 0.21±0.4 ng/ml (median±standard deviation) to 1.01±1.37 ng/ml (P<0.01), but was normal only in 2 patients (7%) (normal values 2.41-8.27 ng/ml). In 17 patients treated with 1 g i.m. T.U. at 0, 6, then 12 weeks intervals, evaluated at 1.510 months (median 4.5 months) from the therapy initiation, serum testosterone raised from 0.62±0.77 ng/ml to 5.24±4.2 ng/ml (P<0.01). It was normal in 12 patients (70.5%), low in 1 (5.8%) and high in 4 patients (23.5%). The sexual dysfunction improved in 7/15 patients (46%) on oral T.U. and in 8/10 patients (80%) on i.m. T.U (P=NS). Hematocrit increased to higher values in patients on oral T.U (from 37.5±3.3% to 41.9±4.02, P<0.01) than in patients on i.m. T.U. (from 38.5±4.7% to 41.1±3.9%, P<0.01), P<0.01, in none over 50%. Serum cholesterol and triglycerides did not change significantly after any of the T.U. treatments.
Conclusion: Morning serum levels of testosterone were normal and the sexual function was improved in most patients with central hypogonadism treated with i.m.T.U., but only in few patients treated with oral T.U.