Abstract
Testosterone therapy (TT) is commonly prescribed in men with androgen deficiency. TT has several common side effects. Moreover, the effect of TT on serum prostate specific antigen (PSA) levels has been a matter of debate over the last decade. We aimed to investigate the effect of TT on PSA and haematocrit levels in a cohort of men with androgen deficiency. Complete demographic, clinical and laboratory data from 106 consecutive hypogonadal men treated with TT were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Serum hormones, complete blood count and PSA were measured in every patient at baseline and after 3 months of TT. Descriptive statistics and logistic regression models tested the association between clinical parameters and haematocrit and PSA values. Overall, median (IQR) patient's age and BMI were 54 (44-64) years and 26.2 (34.6-29) kg/m2, respectively. Above all, 63 (59.4%), 32 (30.2%) and 11 (10.4%) men were treated with T undecanoate, enanthate and gel formulation, respectively. Out of 106 men, 28 (26.4%) and 12 (11.3%) participants had PSA and haematocrit worsening (any degree), respectively. Patients who had PSA worsening (60.5 vs. 50.1 years, p=0.04) and haematocrit worsening (63 vs. 55 years, p=0.03) were older. At univariable logistic regression analysis, older age (OR 1.1, p<0.01) and lower baseline PSA values (OR 0.6; p=0.04) were associated with PSA worsening after TT. Similarly, older age (OR 1.2, p=0.04) and lower baseline haematocrit values (OR 0.7; p=0.03) were associated with haematocrit worsening after TT. After accounting for clinical and laboratory values no independent predictors of haematocrit rising were found. Approximately 20% and 10% of hypogonadal men treated with TT experienced PSA and haematocrit worsening. The degree of change was not meaningful and we failed to find any independent predictor of PSA and haematocrit rising in the real-life setting. None
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