Introduction: Male hypogonadism is one of the most common endocrine disorders affecting 5.6% of men aged between 3079 years. Testosterone deficiency (TD) is an independent risk factor for multiple cardiovascular risk factors including obesity, diabetes mellitus, hypertension, dyslipidaemia and endothelial dysfunction. The aims of testosterone replacement treatment (TRT) in hypogonadism are to improve or ameliorate the clinical features and to restore the serum T to physiological levels. Treatment with TRT for hypogonadism is typically lifelong so needs to be safe, effective, convenient and minimise impact on lifestyle. Therefore the frequency of administration, mode of delivery, efficacy and side-effect profile are important.
Methods/design: Records of 155 hypogonadal males treated at the Waikato Endocrine Unit from 19982011 were examined to compare use of testosterone mixed esters, extended-release testosterone pellet implants and testosterone undecanoate depot (TUD). Efficacy of types of TRT in terms of achievement of physiological levels of T over two years, and changes in known risk factors such as Hb & Hct changes, PSA, and lipid profile changes were examined retrospectively.
Results: Mean T levels of men on Sustanon (n=22) ranged 1.6 to 54 nmol/l. Normal serum T trough levels were found in 53% of men using T implants (n=134) compared with 75.5% while using TUD (n=155), P<.0001. Mean Hct levels were higher on TUD than implants, P<.0001, with elevations in Hct managed by dose alterations. PSA elevations were no different on each TRT. HDL levels were sig lower using TUD than T implants, P<.0001, but total cholesterol, triglycerides and LDL were not significantly different by TRT. Only 4.5% of men elected to stop TUD or return to another TRT.
Conclusion: Testosterone undecanoate depot therapy maintained serum T at more physiological levels and was more acceptable to men as compared to other TRT options.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details unavailable.
05 - 09 May 2012
European Society of Endocrinology