Abstract
There is no conclusive evidence as to whether patients with testosterone deficiency (TD) who benefit from testosterone treatment (TRT) must continue the treatment for the rest of their lives. In some patients, the effect of TRT does not maintained after stopping TRT and, some patients show no significant TD symptoms, with normal testosterone levels after TRT cessation. Therefore, we investigated the predictive factors of response maintenance after TRT cessation. A total of 151 men with TD who responded to TRT were followed up for six months after TRT discontinuation. Ninety-two patients (Group I) failed to show response maintenance; 59 patients (Group II) had a maintained response. The groups did not differ in baseline characteristics or the type of TRT (oral, gel, short/long-acting injectables). However, TRT duration was significantly longer (10.7 vs. 5.2 months), and peak total testosterone (TT) level was significantly higher (713.7 vs. 546.1 ng/dL), in Group II than in Group I. More patients regularly exercised in Group II than in Group I (45.8% vs. 9.8%, p < 0.001). A multivariate logistic regression analysis revealed that exercise (B = 2.325, odds ratio = 10.231, p < 0.001) and TRT duration (B = 0.153, Exp(B) = 1.166, p < 0.001) were independent predictive factors of response maintenance. In men with TD who respond to TRT, longer treatment periods can improve the response durability after TRT cessation, regardless of the type of TRT. Additionally, regular exercise can increase the probability of maintaining the response after TRT cessation.
Highlights
Testosterone deficiency (TD) refers to various hypogonadal symptoms resulting from inadequate testosterone production in males
In follow-up results of the BLAST study, which screened a population of 199 patients for 3.8 years, Hackett et al reported that long-term testosterone treatment (TRT) was related to a continuous decrease in waist circumference and an increase in erectile function [5]
Serologic parameters associated with PSA, hemoglobin, hematocrit, and metabolic status did not differ between the two groups
Summary
Testosterone deficiency (TD) refers to various hypogonadal symptoms resulting from inadequate testosterone production in males. Numerous studies have examined the short-term effects of these testosterone agents. Studies that have examined long-term effects of testosterone agents show benefits. In follow-up results of the BLAST study, which screened a population of 199 patients for 3.8 years, Hackett et al reported that long-term testosterone treatment (TRT) was related to a continuous decrease in waist circumference and an increase in erectile function [5]. According to Yassin et al.’s single-center, cumulative, prospective, and registry 10-year study of injectable testosterone undecanoate (TU) treatment on 115 hypogonadal men, endocrine and metabolic parameters continuously improved for up to 7–8 years and were maintained well afterward, without major adverse cardiovascular events [6]. TRT has positive effects on body composition and insulin sensitivity, as well as on sexual symptoms, which are the most typical TD symptoms [4]
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