title: Predictors and clinical consequences of starting androgen therapy in men with low testosterone: results from the SIAMO-NOI registry.
abstract: OBJECTIVE
  Management of late onset hypogonadism (LOH) is not homogenous. The aim of the study is to observe the management of patients with low testosterone (T) in highly specialized Italian centres.
  
  
  METHODS
  The SIAMO-NOI is an observational longitudinal disease registry for the evaluation of the clinical management of patients with low T levels (total T < 12 nmol/L, calculated free T < 225 pmol/l or already in treatment) in 15 Italian centers members of the Italian Society for Andrology and Sexual Medicine (SIAMS). Clinical and biochemical data were collected for four visits during 12 months of observation.
  
  
  RESULTS
  432 patients (mean age 50.9 ± 14.9 years) were enrolled. Of them, 247 men were receiving androgen therapy, whereas 145 were naive. After the first visit (V0), 80 men started androgen therapy, whereas 55 remained untreated during the entire observation. Younger age [odds ratio (OR) 0.57 (0.35-0.92)], total T < 8 nmol/l [OR 4.69 (1.59-13.81)], complaining at least one sexual symptom [OR 11.55 (2.01-66.35)] and reporting more severe lower urinary tract symptoms [OR 1.27 (1.01-1.60)] predicted starting an androgen therapy. Sixty-four men started therapy immediately after V0 and maintained it until the observation end. When compared to V0, they reported an increase in all the domains of the International Index of Erectile Function-15 (IIEF-15), in the sexual and physical subdomains of the Aging Male Scale as well as in the International Prostate Symptom Score. Conversely, the untreated group reported a significant improvement, although lower than the treated group, only in the erectile function domain of the IIEF-15.
  
  
  CONCLUSIONS
  Management of LOH in SIAMS centres is in line with the international guidelines and the newest knowledge about the role of T on prostate health. Androgen therapy is associated with an improvement in all the aspects of sexual life and in the perception of physical strength.
authors.affiliation: Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rastrelli
authors.affiliation: Endocrinology Unit, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Giovannini
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: A E
authors.initials: AE
authors.lastname: Calogero
authors.affiliation: Department of Experimental Medicine, La Sapienza University of Rome, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Gianfrilli
authors.affiliation: Department of Internal Medical Sciences, Endocrinology and Metabolic Diseases Unit, Cagliari, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Serra
authors.affiliation: Endocrinology Unit, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pizzocaro
authors.affiliation: Outpatient Clinic for Endocrinology and Metabolic Diseases, Conversano Hospital, Conversano, Bari, Italy.
authors.forename: V A
authors.initials: VA
authors.lastname: Giagulli
authors.affiliation: Department of Medical Sciences, Division of Endocrinology, Diabetology and Metabolism, University of Turin, Turin, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Motta
authors.affiliation: Section of Reproductive Endocrinology and Andrology, Hospital San Giovanni Calibita Fatebenefratelli Isola Tiberina, University of Rome TorVergata, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Vancieri
authors.affiliation: Andrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Sperandio
authors.affiliation: Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Andò
authors.affiliation: Department of Molecular Medicine, Section of Clinical Pathology and Center for Human Reproduction Pathology, University of Padova, Via Gabelli 63, 35121, Padua, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Selice
authors.affiliation: Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Luca
authors.affiliation: Department of Endocrinological and Medical Sciences, University of Genova, Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cocchiara
authors.affiliation: Endocrine Unit, University of Pisa Medical School and Hospitals, Ospedale di Cisanello, Pisa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Canale
authors.affiliation: Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy. mario.maggi@unifi.it.
authors.forename: M
authors.initials: M
authors.lastname: Maggi
mesh_terms: D000728:Androgens / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000139:chemically induced*; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012042:Registries; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000009:adverse effects*
chemical_list: D000728:Androgens; D013739:Testosterone
keywords: Androgen therapy; Late onset hypogonadism; Lower urinary tract symptoms; Predictors; Sexual symptoms; Testosterone