Treatment of 161 men with symptomatic late onset hypogonadism with long-acting parenteral testosterone undecanoate: effects on body composition, lipids, and psychosexual complaints.
BACKGROUND
Elderly men may suffer from late-onset hypogonadism (LOH). The long-term effects of long-acting testosterone undecanoate (TU) in a large number of LOH men have not yet been reported. Aims.  We analyzed the effects of normalization of plasma testosterone (T) in LOH men.


METHODS
The records of 161 men with LOH (baseline T<300 ng/dL) were reviewed and 100 men had used parenteral TU for >12 months. The mean duration of treatment was 90.6 weeks (54 to 150 weeks).


METHODS
Body mass index (BMI), waist circumference, percentage body fat, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, prostate-specific antigen (PSA), and hematocrit were measured. Further the Aging Male Symptoms' scale (AMS) and the International Index of Erectile Function (IIEF-5 and 15) were scored.


RESULTS
T therapy was associated with a significant decline in waist circumference (P=0.028) and percentage body fat (P<0.001), but no change of BMI. Total cholesterol and LDL cholesterol declined significantly (P=0.005 and P=0.024, respectively), with no significant changes of HDL cholesterol and triglycerides. The scores of sub-scales of AMS (psychological, somotovegetative and sexual factors) decreased (P=0.044, P=0.200 and P=0.071, respectively). The mean IIEF-5 (P=0.011) and IIEF-15 scores (P=0.021) improved significantly. Erectile function domain, orgasmic function domain, sexual desire domain, intercourse satisfaction domain, and overall satisfaction domain improved. Median PSA rose from 0.95 (0.640; 1.558) ng/mL to 1.480 (1.015; 2.275) ng/mL (P<0.001), with 11 patients >4 ng/mL (4.01-13.21). On biopsy there was no evidence for malignancy. The mean hematocrit level increased significantly from 42.3±3.4% to 47.1±3.8%.


CONCLUSIONS
Normalizing serum T in men with LOH resulted in improvement of the metabolic syndrome, mood and sexual functions and appeared acceptably safe.
Permpongkosol
Sompol
S
Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. sompolpermpongl@gmail.com
Tantirangsee
Nakorn
N
Ratana-olarn
Krisada
K
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000728:Androgens / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D001823:Body Composition / Q000187:drug effects*; D015992:Body Mass Index; D006305:Health Status Indicators; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy* / Q000523:psychology; D007263:Infusions, Parenteral; D008055:Lipids; D008297:Male; D008875:Middle Aged; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy* / Q000523:psychology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D013997:Time Factors
D000728:Androgens; D008055:Lipids; D013739:Testosterone; C010792:testosterone undecanoate