Abstract
PurposeSymptoms of hypogonadism are often reported by subjects with normal serum testosterone (T) levels. We aimed to assess the association between clinical symptoms in andrological outpatients and sex steroids levels.MethodsThis is a retrospective cross-sectional cohort study in an Academic clinic and research unit. International Index of Erectile Function (IIEF, EF domain) and Aging Males Symptoms scale (AMS) questionnaires were completed by 635 and 574 men, respectively (mean age: 47.3 ± 13.9 and 47.4 ± 13.8 years, p = 0.829), free of interfering medications with complaints possibly related to hypogonadism.ResultsSerum total/free T as well as dihydro-T (DHT) was associated with IIEF-EF and AMS scores in the overall population using univariate analyses. Multivariate approaches revealed DHT concentrations in subjects with normal T levels (n = 416, Total T > 12 nmol/L) to be significant predictors of AMS scores. A 0.1 nmol/l serum DHT increase within the eugonadal range was associated with a 4.67% decrease in odds of having worse symptoms (p = 0.011). In men with biochemical hypogonadism (Total T < 12 nmol/L), total and free T rather than DHT were associated with AMS results. This association was not found for IIEF-EF scores. Indirect effects of age and BMI were seen for relations with hormone concentrations but not questionnaire scores.ConclusionDHT can be associated with symptoms of hypogonadism in biochemically eugonadal men. Serum DHT measurement might be helpful once the diagnosis of hypogonadism has been ruled out but should not be routinely included in the primary diagnostic process.
Highlights
Treatment of male hypogonadism has been one of the most controversial topics in endocrinology during the last few years
BMI had low-moderate negative correlation with all androgens (T, rho = − 0.40, p < 0.001; FTc, rho = − 0.27, p < 0.001; DHT, rho = − 0.39, p < 0.001); marginal effect size was observed for correlation between age and other variables included in analysis
When assessing the interaction between DHT and hypogonadism, we observed a difference between hypogonadal and eugonadal subjects: no significant interaction for DHT was present in subjects with low T; whereas in eugonadal subjects, higher DHT levels were significantly associated with less symptomatic Aging Males Symptoms scale (AMS) categories
Summary
Treatment of male hypogonadism has been one of the most controversial topics in endocrinology during the last few years. Most of the reported side effects of T administration had occurred in subjects with high baseline serum T—i.e., subjects who should not have received any kind of androgen replacement therapy—in the hope of improving sexual health and/or physical function. This has led to an FDA warning allowing the use of T only in cases of confirmed low T levels and only in “men with disorders of the testicles, pituitary gland or brain that cause. Guidelines for the treatment of men with functional hypogonadism have recently been published [3]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
