Effects of androgen substitution on lipid profile in the adult and aging hypogonadal male.
The decrease in serum bioavailable testosterone may be responsible for the catabolic sequelae noticed in the aging man (decrease in libido, decrease in muscle mass, osteoporosis and increase in adiposity). After a brief review of androgen and lipid metabolism as well as their modifications with aging, we discuss current knowledge of the effects of androgen substitution on the lipid profile in hypogonadal men. The results of studies concerning the effect of androgen substitution therapy on lipids are conflicting but might be favorable. The small decrease in high-density lipoprotein cholesterol observed when administering standard dosages of testosterone is accompanied by a significant decrease in total cholesterol (CT) and low-density lipoprotein cholesterol. A counterbalancing of these effects plausibly accounts for the absence of increase cardiovascular risk. The currently available preparations are oral, injectable or transdermal formulations of natural testosterone. The development of new androgen preparations that are more potent, metabolically stable and tissue-specific will improve therapeutic benefits and reduce side effects. (+info)
Effect of 12 month oral testosterone on testosterone deficiency symptoms in symptomatic elderly males with low-normal gonadal status.
BACKGROUND: Relative androgen deficiency in ageing males is assumed to have adverse health effects. This study assessed the effect of 12 months' standard dose, oral testosterone, on symptoms attributed to testosterone deficiency in older men with plasma testosterone levels in the low-normal range for young men. METHODS: Testosterone undecanoate (TU, 80 mg bid) or placebo was administered for one year to 76 healthy men, 60 years or older, with a free testosterone index (FTI) of 0.3-0.5 and significant symptoms on a questionnaire designed to evaluate androgen deficiency (ADAM). The ADAM was completed at baseline, 6 and 12 months. Hormone and safety data were collected at baseline, 1, 3, 6 and 12 months. RESULTS: After 12 months, plasma total testosterone was unchanged in both groups and sex hormone binding globulin decreased in the testosterone group (P = 0.01). FTI and calculated bioavailable testosterone (cBT) were greater in the testosterone group as compared with the placebo group (P = 0.021 and 0.025, respectively). There was no significant difference in total symptom score between testosterone and placebo groups after 12 months of oral TU. However, there were trends toward improvements in sadness/grumpiness (P = 0.063), reduced erection strength (P = 0.059) and decreased work performance symptoms (P = 0.077), particularly in men with baseline cBT levels below 3.1 nmol/l. CONCLUSIONS: This study concludes that 80 mg bid oral TU does not improve overall ADAM questionnaire scores in older men with low-normal gonadal status. Oral TU may preserve mood and erectile function, as assessed by this questionnaire, particularly in men with the lowest testosterone levels. (+info)
Increased carotid atherosclerosis in andropausal middle-aged men.
OBJECTIVES: This study examined the association between carotid artery intima-media thickness (IMT), serum sex hormone levels, and andropausal symptoms in middle-aged men. BACKGROUND: Male sex hormones may play a dual role in the pathogenesis of atherosclerosis in men by carrying both proatherogenic and atheroprotective effects. METHODS: We studied 239 40- to 70-year-old men (mean +/- SD: 57 +/- 8 years) who participated in the Turku Aging Male Study and underwent serum lipid and sex hormone measurements. Ninety-nine men (age 58 +/- 7 years) were considered andropausal (i.e., serum testosterone <9.8 nmol/l or luteinizing hormone [LH] >6.0 U/l and testosterone in the normal range), and in both situations, they had subjective symptoms of andropause (a high symptom score in questionnaire). Three were excluded because of diabetes. The rest of the men (age 57 +/- 8 years) served as controls. Carotid IMT was determined using high-resolution B-mode ultrasound, and serum testosterone, estradiol (E2), LH, and sex hormone-binding globulin were measured using standard immunoassays. RESULTS: Andropausal men had a higher maximal IMT compared with controls in the common carotid (1.08 +/- 0.34 vs. 1.00 +/- 0.23, p < 0.05) and in the carotid bulb (1.44 +/- 0.48 vs. 1.27 +/- 0.35, p = 0.003). Common carotid IMT correlated inversely with serum testosterone (p = 0.003) and directly with LH (p = 0.006) in multivariate models adjusted for age, total cholesterol, body mass index, blood pressure, and smoking. CONCLUSIONS: Middle-aged men with symptoms of andropause, together with absolute or compensated (as reflected by high normal to elevated LH) testosterone deficiency, show increased carotid IMT. These data suggest that normal testosterone levels may offer protection against the development of atherosclerosis in middle-aged men. (+info)
Laboratory diagnosis of late-onset male hypogonadism andropause.
Proportion and acceptance of andropause symptoms among elderly men: a study in Jakarta.
AIM: To evaluate the prevalence of men with andropause based only on screening questioner (aging male symptoms, AMS) and their acceptance of the symptoms and factors, which influence the acceptance. METHODS: This cross-sectional study was performed from male visitors in Cipto Mangunkusumo Hospital between February and August 2001. 40 - 90 years old, without significantly severe disease or other conditions that can affect physical, psychological, or sexual activities. They were interviewed by four trained interviewers using a standardized questionnaire, an aging males' symptoms (AMS) questionnaire consisting of 17 items including psychological, somatic and sexual questions. Degrees of andropause were calculated based on the total score of the questionnaire. The participants were also asked about the impact of the symptoms of andropause toward their quality of life (impact question), whether they could accept their condition or not. Data were analyzed using Stata version 8.2 for Windows XP computer packaged. Factors that influenced the acceptance of andropause were analyzed using logistic regression. RESULTS: The proportion of andropause was 70.94 %. Among them, 193 (54.52%) participants were categorized as having mild andropause, followed by 138 (38.95%) as intermediate, and only 23 (6.5%) with severe andropause. Among the 354 participants who experienced andropause, only 124 (35.03%) could not accept their condition, while the rest 230 participants (64.97%) could accept the symptoms of andropause. The degree of andropause and marriage status can affect the acceptance of andropause. The more severe the degree of andropause, the more they cannot accept the conditions (OR 2.19, 95%CI 1.28; 3.73). The married men are more tolerant to their conditions compared to the widower (OR 2.4, 95%CI 1.08; 5.32). The white collar workers are more willing to accept the symptoms of andropause than the blue-collar workers (OR 2.07, 95%CI 1.28; 3.73). CONCLUSION: The proportion of the andropause based only on AMS is high, but only small portion that cannot accept the condition. Married man and white-collar workers are more willing to accept the symptoms of andropause. (+info)
Evaluation of late-onset hypogonadism (andropause) treatment using three different formulations of injectable testosterone.