title: Effect of 12 month oral testosterone on testosterone deficiency symptoms in symptomatic elderly males with low-normal gonadal status.
abstract: 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.
authors.affiliation: University of Adelaide, Department of Medicine, Adelaide, South Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Haren
authors.forename: Ian
authors.initials: I
authors.lastname: Chapman
authors.forename: Penelope
authors.initials: P
authors.lastname: Coates
authors.forename: John
authors.initials: J
authors.lastname: Morley
authors.forename: Gary
authors.initials: G
authors.lastname: Wittert
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D047649:Andropause / Q000187:drug effects*; D001682:Biological Availability; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D007989:Libido / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012016:Reference Values; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000097:blood / Q000172:deficiency*
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; C010792:testosterone undecanoate