(295) Characterizing Testosterone Transference Risk Among Men Undergoing Evaluation for Low Testosterone

Abstract

Abstract Introduction Pre-pubertal exposure to exogenous testosterone (T) is known to cause virilization and precocious puberty (PP). Thus, the AUA and the US Food and Drug Administration have warned of the risk of transference associated with T gels/creams. Yet, little is known about the testosterone transference risk (TTFR) profiles of men undergoing evaluation for low T. Objective We aimed to identify the prevalence of TTFR in men undergoing evaluation for low T. Methods This retrospective analysis included all men with TTFR documented during evaluation for low T at our institution. Total/free T were measured using LCMS/equilibrium dialysis in an early morning fashion. Patients were asked for frequency of contact with at least one child ≤ 12 years old. TTFR was deemed as high if the patient reported a frequency of contact ≥1/month with a pre-pubertal child; all other patients were classified as having low TTFR. Demographic, comorbidities and hormone profile at the time of TTFR assessment were analyzed. Results 118 men had TTFR documented. Median age was 62 (48, 70) years; 20% were ≤ 40 years, 27% were 41-60 years, 53% were ≥ 61 years. Median number of comorbidities was 2 (0, 2); 36% of men had two or more comorbidities. 17% had diabetes. 97% of men had a history of cancer: prostate 57%, testis 22%, bladder 4%, hematologic 8%, pituitary neoplasm 2%. Median T level was 220 (170, 310) ng/dL, free T 6.6 (5.3, 10.7) ng/dL, estradiol 14 (11, 19) pg/mL, luteinizing hormone 4.3 (2.5, 8.9) IU/L, hemoglobin A1c 5.6 (5.3, 6.1)%, and hematocrit 43 (40, 45)%. Regarding TTFR, 53% of men were classified as high-risk for T transference based on the a priori definition utilized. In the overwhelming majority of instances, high TTFR was associated with family contact (children and grandchildren). Patient occupation (pediatrician, counselor) was the second most cited reason for high TTFR. Conclusions Among men being evaluated for low T, more than half had a high TTFR. These findings suggest that the TTFR assessment prior to start T therapy is critical, that high TTFR is highly prevalent, and that TTFR should be documented and discussed with the patients during T therapy counseling. Disclosure No.