Late-onset hypogonadism: the advantages of treatment with human chorionic gonadotropin rather than testosterone.
The traditional pharmacological treatment of patients with late onset hypogonadism (LOH) is represented by different formulations of testosterone (T) or alternatively by the extractive human chorionic gonadotropin (HCG). The hormone replacement treatment (HRT) is associated with the potential increase of hematocrit, serum concentrations of prostate-specific antigen (PSA) and prostate volume. Moreover, the gynecomastia represent a condition frequently associated with HRT. Recent evidences showed the role of leydig cells in the 25-hydroxylation of vitamin D and the elevated frequency of hypovitaminosis D among LOH patients. Finally, another important aspect of LOH is represented by the frequency of secondary infertility due to age or to traditional HRT. This study evaluated 40 LOH patients treated for 6 months with extractive HCG (n = 10 patients) and three different formulations of T: transdermal (n = 10 patients), undecaonate (n = 10 patients) and enantate (n = 10 patients). Hormonal, anthropometric, metabolic and sperm parameters were evaluated and compared. Moreover, the main safety parameters and the results of the main questionnaires were evaluated. After treatment, HCG group showed serum concentrations of 25-OH-vitamin D significantly higher (p < 0.05) and serum concentrations of oestrogens significantly lower (p < 0.05) compared with other groups. Moreover, they showed a mean value of hematocrit, PSA and prostate volume significantly lower (p < 0.05) compared with other groups. Finally, all the groups treated with T showed a significant reduction (p < 0.05) of sperm density and of percentage of spermatozoa with progressive motility compared with HCG group.
a Department of Clinical and Experimental Medicine and.
Sandro
S
La Vignera
a Department of Clinical and Experimental Medicine and.
Rosita Angela
RA
Condorelli
a Department of Clinical and Experimental Medicine and.
Laura
L
Cimino
b Department of Urology , University of Catania , Catania , Italy.
Giorgio Ivan
GI
Russo
b Department of Urology , University of Catania , Catania , Italy.
Giuseppe
G
Morgia
a Department of Clinical and Experimental Medicine and.
Aldo E
AE
Calogero
D000279:Administration, Cutaneous; D006063:Chorionic Gonadotropin / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D006400:Hematocrit; D020249:Hormone Replacement Therapy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007006:Hypogonadism / Q000150:complications / Q000188:drug therapy*; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000187:drug effects; D017430:Prostate-Specific Antigen / Q000097:blood; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000009:adverse effects / Q000627:therapeutic use*; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000209:etiology
D006063:Chorionic Gonadotropin; D014807:Vitamin D; D013739:Testosterone; D017430:Prostate-Specific Antigen
Human chorionic gonadotropin; late onset hypogonadism; testosterone