Background: Intramuscular long acting testosterone injections are widely used, convenient form of androgen replacement in patients with hypogonadism.
Aims: To evaluate the long term effects of parenteral long acting testosterone replacement on patients commenced on treatment in years 20062014 and adherence to monitoring undertaken by primary care after discharge from specialist service.
Method: We reviewed the results of 64 patients (mean age 58.5 years). Indications for starting testosterone treatment were both primary and secondary hypogonadism. Patients were followed up for an average of 4.33 years (between 3 months and 9 years). Total follow up time was 277.2 patient-years. 53 patients continued with treatment, seven patients discontinued the treatment and four patients died during the follow up period time. We followed the changes of the following blood tests: alanine transaminase (ALT), aspartate transaminase (AST), total cholesterol (TC), haematocrit (HCT), haemoglobin (Hb), prostate-specific antigen (PSA) and testosterone. Adherence to the advised monitoring intervals of these parameters was reviewed.
Results: Over the follow up period time the mean changes in the results were as follows: ALT +1.05 IU/l (+5%), TC -0.41 mmol/l (-8.1%), HCT +0.030 (+7.0%), Hb +7.06 g/l (+4.9%), PSA +0.91 μg/l (+96%), testosterone +19.2 nmol/l (+206%). Adherence to the monitoring intervals advised by our specialist service was: ALT 78.9%, HCT and Hb 80.3%, PSA 52.2% and testosterone 66.3%.
Conclusions: Long acting parenteral testosterone replacement in our group of patients resulted in insignificant changes in liver function tests, haematocrit and haemoglobin. We observed a rise in PSA levels, although the mean value remained in the normal range. Reduction of TC levels was noticed and testosterone replacement is reported in the literature to have no adverse effects on lipid profiles. Adherence to the advised monitoring intervals, especially for PSA and testosterone levels needs further attention.