MP89-06 PRESERVATION OF NORMAL CONCENTRATIONS OF PITUITARY GONADOTROPINS DESPITE ACHIEVEMENT OF NORMAL SERUM TESTOTERONE LEVELS IN HYPOGONADAL MEN TREATED WITH A 4.5% NASAL TESTOSTERONE GEL

Abstract

You have accessJournal of UrologyInfertility: Therapy I1 Apr 2017MP89-06 PRESERVATION OF NORMAL CONCENTRATIONS OF PITUITARY GONADOTROPINS DESPITE ACHIEVEMENT OF NORMAL SERUM TESTOTERONE LEVELS IN HYPOGONADAL MEN TREATED WITH A 4.5% NASAL TESTOSTERONE GEL William Conners, MD, Abraham Morgentaler, MD, Margaux Guidry, PhD, Gerwin Westfield, PhD, Nathan Bryson, PhD, and Irwin Goldstein, MD William Conners, MDWilliam Conners, MD More articles by this author , Abraham Morgentaler, MDAbraham Morgentaler, MD More articles by this author , Margaux Guidry, PhDMargaux Guidry, PhD More articles by this author , Gerwin Westfield, PhDGerwin Westfield, PhD More articles by this author , Nathan Bryson, PhDNathan Bryson, PhD More articles by this author , and Irwin Goldstein, MDIrwin Goldstein, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2804AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES One of the recognized effects of standard forms of testosterone (T) therapy is suppression of the pituitary gonadotropins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) via negative feedback from sustained increases in serum T concentrations. We report here the results of treatment with a 4.5% testosterone gel administered intranasally (nasal testosterone gel - NTG) on serum total testosterone (TT), LH, and FSH in hypogonadal men. METHODS Hypogonadal men were randomized into a 90-day, open-label, dose-ranging study. A 4.5% NTG (125 uL/nostril, 11.0mg testosterone/dose) was self-administered using a multiple-dose dispenser either twice daily (BID, n=122) or 3 times a day (TID, n=151) for a total dose of 22.0mg or 33.0mg, respectively. Titration was performed based on blood levels so as to achieve the eugonadal range (300 -1050 ng/dL). Serum samples were obtained at baseline and after 90 days of treatment to determine relevant hormone levels. RESULTS Total serum testosterone increased from a mean Cavg 200.8 ng/dL at baseline to a mean Cmax 818.49 ng/dL at ~40 minutes. After 90 days, 90% (95% CI = 83-97%) of men in the TID group, and 71% (95% CI = 62-79%) of men in the BID group reached normal T levels, and a mean total testosterone Cavg 421 ng/dL and 375 ng/dL, respectively. Baseline FSH (BID) was 8.49 IU/L, mean at Day 90 was 5.99 IU/L. Baseline FSH (TID) was 6.42 IU/L, mean at Day 90 was 3.12 IU/L. Baseline LH (BID) was 5.42 IU/L, mean at Day 90 was 3.56 IU/L. Baseline LH (TID) was 5.25 IU/L, mean at Day 90 was 2.20 IU/L. CONCLUSIONS Treatment with 4.5% NTG restored serum TT to normal levels while FSH and LH levels were reduced but remained well within the normal range mitigating the decline in LH and FSH. This maintenance of normal gonadotropins differs from the usual suppression seen with other exogenous T preparations, particularly injections. The mechanism for this reduced gonadotropin suppression is uncertain, but may be due to return of serum T to baseline between doses. Further studies are needed to determine to what extent this reduced gonadotropin suppression may result in preservation of testicular volume and fertility. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1204 Advertisement Copyright & Permissions© 2017MetricsAuthor Information William Conners, MD More articles by this author Abraham Morgentaler, MD More articles by this author Margaux Guidry, PhD More articles by this author Gerwin Westfield, PhD More articles by this author Nathan Bryson, PhD More articles by this author Irwin Goldstein, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...