Daily subcutaneous testosterone for management of testosterone deficiency
Abstract
Testosterone deficiency (TD) is a public health concern, a predictor of metabolic syndrome, and is associated with an increased all-cause and cardiovascular mortality. Testosterone deficiency in men is treated by a variety of methods including injectable testosterone compounds, patches, gels, pellets, and oral preparations. The use of testosterone alone has been linked to various adverse effects including, infertility, testicular atrophy, erythropoiesis, and gynecomastia. To determine the effectiveness of therapy using the Daily Subcutaneous Testosterone (DST) method in combination with human chorionic gonadotropin (hCG) and an aromatase inhibitor (anastrozole), a retrospective analysis was conducted of men diagnosed and treated for TD. Changes in testosterone, estradiol, sex hormone binding globulin (SHBG), luteinizing hormone (LH), follicle stimulating hormone (FSH), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), prostate-specific antigen (PSA), pregnenolone, and hemoglobin were determined. There was a significant increase in total testosterone, free serum testosterone, and direct free testosterone in the testosterone treated patients. There was a significant increase in total and free testosterone levels with the DST method combined with hCG and anastrozole, suggesting that DST therapy is a viable option to restore testosterone levels in men.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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