Benefits of Treating Hypogonadism

[marcus300]

Benefits of Treating Hypogonadism



What are the Benefits of Treating Hypogonadism?


Sexual dysfunction and low libido are among the most easily reversible symptoms of hypogonadism. Systematic reviews of randomized, placebo-controlled clinical trials of testosterone in men, including older men (aged 60 years and over) and middle-aged men, with sexual dysfunction and hypogonadism have shown large favourable effects on libido and moderate effects on satisfaction with erectile function.1-5 In men who do not respond sufficiently to testosterone therapy alone, the combination of phosphodiesterase 5-inhibitors and testosterone may be indicated, as there are suggestions that the combination may be synergistic.1

Depression, well-being, cognitive function
Alterations in mood and depression are a symptom of, but not confined to, hypogonadism.1,6 Outcomes in clinical trials of the effect of testosterone treatment on mood have varied. However, there is evidence that testosterone treatment results in improvements in mood, particularly in older men with hypogonadism.7,8Similarly, although there is an established association between measures of cognitive ability and serum levels of testosterone , the benefits of testosterone treatment on cognition are less clearly established, with some studies reporting improvements in some measures of cognitive function and others failing to detect benefits.6,9-11 Although a potential role for testosterone in protecting cognitive function and preventing Alzheimer’s disease has been proposed by some researchers, confirmation from appropriately-designed clinical trials is awaited.

Body composition
Testosterone therapy improves body composition (increase in lean body mass, decrease in fat mass) in men with hypogonadism.1 There is a supplementary improvement in muscle strength and physical function. The benefits of testosterone treatment on body composition have consistently been demonstrated in clinical studies of testosterone therapy in hypogonadal men or men with borderline low testosterone levels ,1,6,8,12,13 and confirmed by systematic reviews or meta-analyses of randomized controlled trials.4,5,6,13

Cardiovascular risk
There is a large body of evidence linking the onset and/or progression of cardiovascular disease to low testosterone levels in men. It is now apparent that an increased cardiovascular risk and accelerated development of atherosclerosis occurs not only in elderly men or men with obesity or type 2 diabetes mellitus, but also in non-obese men with hypogonadism.14 Current best evidence from systematic review of randomized controlled trials suggests that testosterone use in hypogonadal men is relatively safe in terms of cardiovascular health and do not produce unfavorable elevations in blood pressure or glycemic control, and does not adversely effect lipid profiles.4,15

In fact, there is increasing evidence of the potential benefits of testosterone replacement therapy on multiple cardiovascular risk factors. This evidence recently has been comprehensively reviewed by Traish et al. in the Journal of Andrology.16 Although the full effects of testosterone replacement therapy on cardiovascular risk are yet to be established, the balance of emerging evidence from clinical studies suggests that testosterone replacement therapy in hypogonadal men may improve endothelial function, reduce proinflammatory factors, reduce hypertension, and improve the lipid profile.

Diabetes and metabolic syndrome
Hypogonadism is highly prevalent amongst men with diabetes mellitus type 2 or symptoms of the metabolic syndrome, including insulin resistance, impaired glucose regulation, obesity, and hypertension.1,6,13,14,17,18 Low testosterone in many men with diabetes remains undiagnosed and untreated, and current guidelines recommend measurement of testosterone levels in such patients and, equally, that such chronic diseases should be investigated and treated in men with hypogonadism.1,6 It is not yet fully known whether diabetes is a cause or a consequence of low testosterone, and the full effects of testosterone administration on glycemic control in hypogonadal men with diabetes are unclear. However, there are indications that treating hypogonadism may have benefits on metabolic status in men with diabetes, and there is evidence that testosterone replacement therapy has a beneficial effect on risk factors for diabetes such as central obesity, insulin sensitivity, glucose control and blood lipid profiles in hypogonadal men with type 2 diabetes.14,19,20

Bone health
Low testosterone can lead to reduced bone mineral density and osteoporosis, and men with hip fractures tend to have low testosterone.1,6 For example, in a matched case-control study at a hospital orthopedic service, 71% of men with hip fractures had low testosterone levels, compared with 32% of age-matched controls.21

A large number of trials have shown the positive effects of testosterone treatment on markers of bone formation and increased bone density in hypogonadal men treated with testosterone.1,4,6,8,13 Not surprisingly, the effects may take several years to fully develop. At present no data on the role of testosterone in preventing fracture in men with hypogonadism are available.

References

1 Wang, C., E. Nieschlag, R. Swerdloff, et al. Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol 2008, 159(5): 507-514

2 Bayer Pharma AG. Global Nebido Satisfaction Study 2009

3 Boloña ER, Uraga MV, Haddad RM, et al. Testosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials. Mayo Clin Proc 2007; 82(1): 20-8

4 Gruenewald DA, Matsumoto AM. Testosterone supplementation therapy for older men: potential benefits and risks. J Am Geriatr Soc 2003; 51(1): 101-15

5 Isidori AM, Giannetta E, Greco EA, et al. Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: a meta-analysis. Clin Endocrinol (Oxf) 2005; 63(3): 280-93

6 Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2006; 91(6): 1995-2010

7 Wang C, Alexander G, Berman N, et al. Testosterone replacement therapy improves mood in hypogonadal men--a clinical research center study. J Clin Endocrinol Metab 1996; 81(10): 3578-83

8 Wang C, Cunningham G, Dobs A, et al. Long-term testosterone gel (AndroGel ) treatment maintains beneficial effects on sexual function and mood, lean and fat mass, and bone mineral density in hypogonadal men. J Clin Endocrinol Metab 2004; 89(5): 2085-98

9 Barrett-Connor E, Goodman-Gruen D, Patay B. Endogenous sex hormones and cognitive function in older men. J Clin Endocrinol Metab 1999; 84(10): 3681-5

10 Moffat SD, Zonderman AB, Metter EJ, et al. Longitudinal assessment of serum free testosterone concentration predicts memory performance and cognitive status in elderly men. J Clin Endocrinol Metab 2002; 87(11): 5001-7

11 Yaffe K, Lui LY, Zmuda J, et al. Sex hormones and cognitive function in older men. J Am Geriatr Soc 2002; 50(4): 707-12

12 Qoubaitary A, Swerdloff RS, Wang C. Advances in male hormone substitution therapy. Expert Opin Pharmacother 2005; 6(9): 1493-506

13 Stanworth RD, Jones TH. Testosterone for the aging male; current evidence and recommended practice. Clin Interv Aging 2008; 3(1): 25-44

14 Traish AM, Saad F, Guay A. The dark side of testosterone deficiency: II. Type 2 diabetes and insulin resistance. J Androl 2009; 30(1): 23-32

15 Haddad RM, Kennedy CC, Caples SM, et al. Testosterone and cardiovascular risk in men: a systematic review and meta-analysis of randomized placebo-controlled trials. Mayo Clin Proc 2007; 82(1): 29-39

16 Traish AM, Saad F, Feeley RJ, et al. The dark side of testosterone deficiency: III. Cardiovascular disease. J Androl 2009; 30(5): 477-94

17 Barrett-Connor E. Lower endogenous androgen levels and dyslipidemia in men with non-insulin-dependent diabetes mellitus. Ann Intern Med 1992; 117(10): 807-11

18Gray A, Feldman HA, McKinlay JB, et al. Age, disease, and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Aging Study. J Clin Endocrinol Metab 1991; 73(5): 1016-25

19 Kapoor D, Goodwin E, Channer KS, et al. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes. Eur J Endocrinol 2006; 154(6): 899-906

20 Kapoor D, Jones TH. Androgen deficiency as a predictor of metabolic syndrome in aging men: an opportunity for intervention? Drugs Aging 2008; 25(5): 357-69

21 Jackson JA, Riggs MW, Spiekerman AM. Testosterone deficiency as a risk factor for hip fractures in men: a case-control study. Am J Med Sci 1992; 304(1): 4-8

[michaelawlker]

That was very interesting information that I have read in above post. Testosterone therapy increase body in lean body mass, decrease in fat mass as well as it plays main role to decrease bone mineral density and osteoporosis.

[Gpaltrow]

Hi Marcus,

Do you know if the post-SSRI syndrom is actually hypogonadism induced by antidepressants ? Too much cortisol in the pituitary gland after the end of the treatment ?

LC

[David LoPan]

Do you have any suggestions for what to take to help combat hypogonadism? I have read a few post on HCG but they all seem to be older posts. I have found that finding or getting a RX for HCG is pretty easy but since the new diet associated with HCG the cost is very high. I am in the medical field but my PCP thinks that HCG is just a fad. I tend to agree as it relates to women, but have learned a lot about the benefits for men.

I am currently taking Test C (rx is for 100mg q 2weeks) but now taking it every week along with Tren . Have seen big gains in gym but not down in the gonads. Diet is now clean, finally kicked my addiction to chips. I take supplements and shakes but the new ones have been Raspberry Ketone and CLA with meals. And since I started with the Tren and increased Test C I have added Plant Sterol Complex to combat the HDL / LDL side effects of them.

Any suggestions?

[powerlifterty16]

sounds like you are on a steroid cycle and not trt..why tren ? hcg is not a fad..it is absically lh...and if your balls are working it will keep them working and increase your t..you can even ditch the test and tren and use hcg only, but many report feeling best ona combo of t and hcg.

how is the plant sterol working, and did your cholesterol get worse on trt? any link to the plant sterol you bought?

[David LoPan]

sounds like you are on a steroid cycle and not trt..why tren ? hcg is not a fad..it is absically lh...and if your balls are working it will keep them working and increase your t..you can even ditch the test and tren and use hcg only, but many report feeling best ona combo of t and hcg.

how is the plant sterol working, and did your cholesterol get worse on trt? any link to the plant sterol you bought?

What I meant about hcg is it is a diet trend, around here anyways, where you go on a 500 cal diet and take hcg shots and lose a lot of weight. Anyone that is on a 500 cal diet is going to lose weight. We have several weight loss clinics around here that only do hcg for weight loss and it is costly. I know a lot of women that got pregnant due to this diet too. So my PCP (primary care physician) thinks / only knows of hcg as a weight loss drug. I have seen my PCP for 15 years now.

Yes, I am on a cycle now. I have been on a low T regiment for a long time. I have a very low T level. My workout friend at the gym (known since 7th grade) suggested I increase my T and add tren for weight training. I was not seeing the results like I did when I was back in my 20's and 30's. It has really worked out well. I had never tried gear before for training and wow I am impressed. I have only been addicted to patato chips but I love the results I am seeing with the increase of t and the addition of tren. I might become addicted, it has helped with sleep, weight, weight training, diet and sex life.

As for the Cholesterol, I work on a cardiac unit (i am a nurse) and I know what the effects of high cholesterol can do. There has been some studies from the military (sorry cant source at the moment) that showed that heart disease can start around 20. Anyone that is KIA has an autopsy done so this was there they got their evidence based studies came from.

My Chol was around 180 before I started taking the plant sterols and it dropped to around 130. I take Metagenics Meta Sitosterol 2.0 -- 90 Tablets, 1 tab HS. Oh HS is at bedtime. I also take 162 mg of asprin (asa) at the HS as well. This is not due to needing to take it, but more I would rather take it and not need it then need it and not take it. But since I stared researching here on gear I didn't want my ldl/hdl ratios to go up, so I started taking them again. I also take Metamucil in the AM to help with both Chol and being regular. The reason I take Metagenics Meta Sitosterol is due to a cardiologist sells it and he did a lot of research on plant sterols, but most importantly I get it free. When he as a bottle getting ready to expire he gives it to me, and I tell all of his patients they should but it from him. Win / win. I do know that Metagenics has a strict 30% flat markup. Not bad compared to other products I have seen.

I was wondering about taking Pregnenolone and DHEA both on cycle and post cycle? And if hcg worked well just post cycle or if you can do it while on cycle to help make the boys work / not shrink. If there is anything else I am missing please let me know.

[marcus300]

bump

[guner1904]

bump

and on trt you will have shrinkage it happened to me. also a buddy at work is 56yrs. doc prescribed 250mg (test-C) every other week
he weighs 260lbs and is not a fatty. and confirmed shrinkage. he recently went "on cycle" while continuing his regular TRT dosing and confirmed excessive shrinkage.
ie. more than the small amount that he had on TRT alone. but after the cycle said they came back to "normal" TRT level shrinkage. hope that makes sense bro.