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Keywords:

  • Testosterone Replacement Therapy;
  • Hypogonadism;
  • Aging;
  • Total Testosterone Levels;
  • Free Testosterone;
  • Testosterone Treatment for Hypogonadism

ABSTRACT

Introduction.  Despite increasing medical interest in testosterone therapy (TTh) for men with testosterone deficiency (TD) there is limited information regarding subjective response rates and acceptability of medium- to long-term TTh in routine clinical practice.

Aim.  To evaluate results in a consecutive series of men in clinical practice treated with TTh.

Material and Methods.  A chart review was performed for a consecutive series of men for whom TTh was initiated over 1 year for a clinical diagnosis of TD. A diagnosis of TD was based on the presence of symptoms and on laboratory evaluation indicating total testosterone (<300 ng/dL) or free testosterone (FT) (<1.5 ng/dL). Presenting symptoms were noted at baseline, and improvement was documented in domains of erectile function, libido, energy, and mood.

Main Outcome Measures.  Percentage of men who completed 12 months of TTh, and symptomatic response rates.

Results.  There were 127 men included in the evaluation. The most common presenting symptoms were the combination of erectile dysfunction (ED) and reduced libido in 82 (64.6%), ED alone in 29 (22.8%), and reduced libido alone in 13 (10.2%). Initial mode of TTh was injections (testosterone enanthate or cypionate) in 70 (55.1%) and transdermal gel (Androgel, Solvay Pharmaceuticals, Marietta, GA, USA) in the remainder. Improvements in erections, libido, energy, and/or mood were reported by 70% of men by 3 months. Eighty men (63%) completed 12 months of TTh with subjective benefit (responders). Treatment was discontinued in 34 (26.8%) who reported no major benefit (non-responders), and 13 (10.2%) were lost to follow-up. Among men who discontinued TTh, 64.7% failed to report benefits by 3 months. Baseline FT was lower among responders than non-responders. One case (1.25%) of prostate cancer was identified after one year of TTh.

Conclusion.  Approximately two-thirds of men with TD who begin TTh will experience symptomatic benefit and will complete at least 12 months of treatment. Benefit was noted in a majority by 3 months. Rhoden EL, and Morgentaler A. Symptomatic response rates to testosterone therapy and the likelihood of completing 12 months of therapy in clinical practice. J Sex Med 2010;7:277–283.