Androgen Deficiency In Aging Male Research Articles

A study on hypogonadism in male HIV patients in northeastern part of India.

Context:After the introduction of highly active antiretroviral therapy (ART), the prevalence of hypogonadism among human immunodeficiency virus (HIV)-infected males is decreasing.Aims:The aim of this study was (i) to estimate the prevalence of hypogonadism among HIV-infected males and (ii) to determine the risk factors for hypogonadism.Settings and Design:This was a cross-sectional study undertaken at ART center of a medical Institute.Subjects and Methods:The study recruited HIV-infected males aged 18–65 years receiving ART. Patients with any debilitating chronic illness, diabetes mellitus, chronic smokers or alcoholic, currently on opioids, or methadone were excluded from the study. Androgen Deficiency in Aging Male (ADAM) questionnaire was used to screen patients for the possible presence of hypogonadism. For those screened positive on ADAM questionnaire underwent biochemical evaluation for serum total testosterone, luteinizing hormone (LH), and CD4 count.Statistical Analysis Used:The Chi-square test was used to compare different parameters. Pearson's correlation coefficient was used to assess any relationship between CD4 count, LH, and testosterone. P < 0.05 was considered statistically significant.Results:In the study, 426 were initially screened and 120 patients who had probable hypogonadism were further evaluated. The mean age of the patients was 41.61 years. The mean body mass index (BMI) of the patients was 22.47 kg/m2. The mean duration of ART was 6.13 years and the mean CD4 count was 442.63 cells/mm3. Hypogonadism was seen in 20 (23.3%) and majority (85.7%) had secondary hypogonadism. There was significant association between hypogonadism and CD4 count, but no association was found with BMI and duration of ART.Conclusions:Hypogonadism is seen in 23.3% of HIV-infected males. Majority (85.7%) had secondary hypogonadism. There was significant association of hypogonadism with lower CD4 count.

Evaluation of the effectiveness and safety of a daily dose of 5 mg of tadalafil, over an 8-week period, for improving quality of life among Korean men with andropause symptoms, including erectile dysfunction: A pilot study.

Background:The primary aim of this study was to evaluate the effects of a once-a-day 5 mg dose of tadalafil, prescribed for 8 weeks, on the quality of life (QoL) of South Korean men with andropause symptoms, including erectile dysfunction (ED), using a single group, open-labeled, before-and-after preliminary trial. The secondary objective was to evaluate the effectiveness and safety of tadalafil for ED.Methods:Forty South Korean men (>35 years of age) with andropause symptoms including ED were enrolled into our trial. Andropause syndrome was defined using the androgen deficiency in aging males (ADAM) questionnaire and other screening tests, including testosterone levels. The following outcome measures were obtained at baseline and at 4 and 8 weeks of tadalafil treatment: physical examination, adverse effects, Short Form 12 Health Survey (SF-12) score, International Index of Erectile Function (IIEF-5) score, bioelectrical impedance analysis (BIA), and free radical testing.Results:Treatment increased the SF-12 Mental component score, used as a proxy measure of quality of life, from baseline to at 4 and 8 weeks (P < .05). In addition, the mean IIEF-5 score, which assesses sexual function, increased from baseline at 4 and 8 weeks (P < .05), with this increase being significant at both time points. No adverse effects were noted.Conclusion:Tadalafil (5 mg dose, once daily) is a safe and effective treatment to improve ED, and overall QoL, among Korean men with andropause symptoms, including ED.

Correlations of Self-Reported Androgen Deficiency in Ageing Males (ADAM) with Stress and Sleep among Young Adult Males.

Androgen deficiency in males has traditionally been predominantly limited to older men aged 50+ years. However, little is known of the correlation between hormonal disruption, stress, and sleep in college-aged males. This cross-sectional study investigates lifestyle behavior patterns in young men and a screening for potential androgen deficiency. A survey of 409 male students, as part of a larger USDA-funded GetFruved study, was analyzed for this subproject. Survey instruments used include the Androgen Deficiency in the Aging Male Questionnaire (ADAM) to assess for inadequate ADAM scores, the Perceived Stress Scale to measure stress levels and the Pittsburgh Sleep Quality Index to evaluate sleep quality. In total, 144 male participants (35%) met criteria for potential androgen deficiency defined by the ADAM questionnaire. Correlation was found between having a positive ADAM score and both increased stress levels (p < 0.001) and poor sleep quality (p < 0.001), with stress displaying the strongest effect (p < 0.001 vs p = 0.124). An increased prevalence of having a positive ADAM score versus established norms for this age group was also noted. These findings highlight the need for investigation of endocrine disruptions in young men.

Prevalence of Adult-Onset Hypogonadism and Erectile Dysfunction in Males with Prediabetes

Background: The prevalence of prediabetes is high globally; however, few studies have investigated the prevalence of adult-onset hypogonadism (AOH) and erectile dysfunction (ED) in men with prediabetes, and there is no study from India. Aims: The aim of this study was to evaluate the prevalence of AOH and ED in men with prediabetes and to correlate the risk of testosterone deficiency with prediabetes. Methods: This cross-sectional study was performed on 100 diagnosed cases of prediabetes and 100 normoglycemic controls. Prediabetes was defined as impaired fasting glucose, impaired glucose tolerance, or both. AOH was defined as a positive response in the Androgen Deficiency in Ageing Males (ADAM) questionnaire in the setting of low testosterone. ED was assessed by the International Index of Erectile Function Questionnaire (IIEF-5) score. Results: AOH and ED were diagnosed in 34 (34%) and 79 (79%) males with prediabetes as compared to 16 (16%) and 58 (58%) males in the control population, respectively (p = 0.004 and p = 0.001). Both AOH and ED were observed in significantly more younger males with prediabetes (< 50 years) than in controls. On multivariate analysis, total testosterone remained significantly low in males with prediabetes as compared to controls after adjustment for possible confounders (odds ratio 2.5; p = 0.028). Conclusion: Males with prediabetes even in the younger age group are at an increased risk of AOH, ED, and testosterone deficiency.

Serum Testosterone Level and Response to Androgen Deficiency in Aging Males (Adam) Questionnaire in Chronic Kidney Disease (CKD) - A Single Center Study

Introduction: Abnormalities of serum testosterone level in males are observed in chronic kidney disease (CKD) patients. Erectile dysfunction, decreased libido, infertility in chronic kidney disease (CKD) patients is associated with low serum testosterone. So this study of CKD patients help early recognition of these adverse conditions associated with low serum testosterone level and thus specific actions may be taken earlier.Objective: To evaluate the serum testosterone level and the response of ADAM questionnaire in males with different stages of chronic kidney disease (CKD).Method: This cross sectional study was done From January to December, 2014 in the Department of Nephrology, Dhaka Medical College Hospital. A total of 90 diagnosed cases of adult male with different stages of CKD (CKD stage 3, 4, 5 and 5D) patients along with age matched 88 healthy individuals were included. Every subject was provided the Bangla version of ADAM questionnaire. Serum Testosterone was done by 125I-testosterone RIA system. P values &lt;0.05 was considered as statistically significant.Result: Mean S. testosterone was found 4.29±1.9 ng/ml in CKD patients (group A) and 9.15±1.2 ng/ml in healthy subjects (group B). The mean S. Testosterone difference was statistically significant (p&lt;0.05) between two groups. It was observed that positive response to ADAM questionnaire was found 11.4% in healthy subjects, 10.1% in CKD stage 3, 54.5% in CKD stage 4, 100% in CKD stage 5 and 5D. Among those groups only CKD stage 5 and 5D patients observed low S. testosterone and was found 39.1% and 84.0% respectively.Conclusion: Serum testosterone significantly decreased with progression of CKD stages. Positive ADAM questionnaire also found to be significant in CKD patients.J Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 73-78

Performance of the Androgen Deficiency in Aging Male questionnaire for the clinical detection of androgen deficiency in black sub-Saharan African men with Type-2 diabetes mellitus

Background: The Androgen Deficiency in Aging Male (ADAM) questionnaire is increasingly popular for evaluation of androgen deficiency (AD) in sub-Saharan African men with type 2 diabetes mellitus (DM). However, its reliability in this population is unknown.Methods: Total testosterone < 8 nmol/L was used as the gold standard for diagnosis of AD in this cross-sectional survey of 200 type 2 DM males aged 30–69 years. Participants also completed the Saint Louis University ADAM questionnaire whereby AD was diagnosed by a ‘yes’ answer to question 1 (reduced libido) or 7 (erectile dysfunction) or any other three questions. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy of the ADAM tool were computed.Results: The mean age of the participants was 58.0 ± 8.8 years. A total of 142 subjects (71.0%) had AD based on the ADAM questionnaire. However, AD was biochemically confirmed in 59 subjects (29.5%). The ADAM questionnaire rendered a sensitivity of 8...

Assessment of Hypogonadism in Men With Type 2 Diabetes: A Cross-Sectional Study From Saudi Arabia.

BACKGROUND/OBJECTIVESA high incidence of hypogonadism in men with type 2 diabetes (T2D) has been globally reported. This study aimed to determining the frequency of hypogonadism and related risk factors among men with T2D in a single-site hospital in Saudi Arabia.DESIGN AND METHODSA cross-sectional study was performed on 157 men with T2D (between 30 and 70 years of age). Using a prestructured questionnaire, the demographic features of these patients were gathered and their medical records were referred to gather information regarding the duration of the diabetes, smoking habits, and the presence of retinopathy, neuropathy, and nephropathy. Besides these, the biochemical parameters, total testosterone (TT), free testosterone, sex hormone–binding globulin, follicle-stimulating hormone, luteinizing hormone, prolactin, serum lipids, and glycosylated hemoglobin were also recorded. All the patients submitted the fully completed Androgen Deficiency in Aging Male (ADAM) questionnaire. The combination of symptoms (positive ADAM score) plus a TT level ⩽8 nmol/L constituted the condition of hypogonadism.RESULTSThe total frequency of hypogonadism was 22.9% (36/157). Of the 157 total patients, 123 (78.3%) were shown to be ADAM positive, and of these, 90 (73.2%) exhibited decreased libido, 116 (94.3%) had weak erections, and 99 (80.5%) reported more than 3 symptoms of ADAM. Of these hypogonadic patients, 22.2% (n = 8) revealed primary hypogonadism, whereas 77.8% (n = 28) showed secondary hypogonadism. From the univariate analysis conducted, significant relationship was observed between treatment type, body mass index (BMI), and hypogonadism. The regression analysis showed BMI acting an independent risk factor of hypogonadism.CONCLUSIONSSaudi men with T2D revealed a high incidence of hypogonadism. Body mass index was identified as an independent risk factor for hypogonadism.

Testosterone versus clomiphene citrate in managing symptoms of hypogonadism in men

Introduction:Both clomiphene citrate (CC) and testosterone supplementation therapy (TST) are effective treatments for men with hypogonadism. We sought to compare changes in symptoms and treatment efficacy in hypogonadal men before and after receiving CC and TST.Patients and Methods:52 men who received TST and 23 men who received CC for symptomatic hypogonadism were prospectively followed for change in hormone levels and symptoms after treatment. These men were also compared to eugonadal men who were not on CC or TST during the same period. Comparisons were made between baseline and posttreatment hormone levels and symptoms. Symptoms were evaluated using the androgen deficiency in aging male (ADAM) and quantitative ADAM (qADAM) questionnaires.Results:Serum total testosterone increased from pretreatment levels in all men (P < 0.05), regardless of therapy type (TST: 281–541 ng/dL, CC: 235.5–438 ng/dL). Men taking TST reported fewer ADAM symptoms after treatment (5–2, P < 0.05). Similarly, men taking CC reported fewer ADAM symptoms after treatment (3.5–1.5, P < 0.05). Conversely, eugonadal men had similar T levels (352 vs. 364 ng/dL) and hypogonadal symptoms (1.5 vs. 1.4) before and after follow-up. When we evaluated individual symptoms, men treated with TST showed significant increases in qADAM scores in libido, erectile function, and sports performance. However, among the men who received CC, qADAM subscore for libido was lower following treatment (3.75–3.2, P = 0.04), indicating that CC could have an adverse effect on libido in hypogonadal men.Conclusions:Both TST and CC are effective medications in treating hypogonadism; however, our study indicates that TST is more effective in raising serum testosterone levels and improving hypogonadal symptoms. CC remains a viable treatment modality for hypogonadal men but its adverse effect on libido warrant further study.

Comparing calculated free testosterone with total testosterone for screening and diagnosing late-onset hypogonadism in aged males: A cross-sectional study.

The aim of this study is to compare calculated free testosterone (cFT) and total testosterone (T) in predicting late-onset hypogonadism (LOH) in middle-aged and elderly males. We surveyed a random sample of 608 males between the ages of 45 and 87years from Shanghai, China. The Aging Male Symptoms (AMS) questionnaire and the Androgen Deficiency in Aging Male (ADAM) questionnaire were completed by the subjects. Testosterone (T), sex hormone-binding globulin (SHBG), albumin, and other blood biochemical indexes were measured in 332 males. The corresponding cFT was obtained using the Vermeulen formula and the correlations between T and cFT were analyzed by SPSS statistical software. Among the 332 males who underwent biochemical evaluation, 289 males (87.0%) was positively screened by the ADAM questionnaire and 232 males (69.9%) by the AMS questionnaire. As suggested by linear regression, cFT exhibited a negative correlation with age in both ADAM+ and AMS+ group, whereas T did not appear to have significant correlation with age. Besides, there were statistically significant differences in cFT (P<.001) in the AMS questionnaire. Calculated free testosterone levels are more reliable than T levels for diagnosing LOH in middle-aged and elderly males.

Hypogonadism in Nigerian men with type 2 diabetes mellitus

Hypogonadism in patients with diabetes mellitus (DM) has been associated with insulin resistance and poor glycaemic control. This study was conducted to determine the prevalence, types, and associations of hypogonadism in Nigerian men with established type 2 diabetes mellitus. The study was a cross-sectional observational work, which was conducted at the Lagos University Teaching Hospital (LUTH). The participants consisted of 108 men with type 2 DM and 56 non-diabetic controls. A questionnaire was used to obtain demographic data while the Androgen Deficiency in Aging Male (ADAM) questionnaire was administered to elicit symptoms of hypogonadism. The enzyme-linked immunosorbent assay (ELISA) method was used to test for serum-free testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and estradiol. Other investigations done included fasting lipid profile, fasting plasma glucose, and glycated haemoglobin (HbA1c). Statistical analysis was done with SPSS v20. Tests of normality were carried out on the data to determine appropriate statistical analytic methods. The mean (±SD) ages of the DM patients and controls were 51.7 ± 5.9 and 50.9 ± 4.6 years, respectively (p = 0.349), with a mean duration of diabetes 93.6 ± 6.29 months. Among the DM patients, 17 (15.7 %) were obese, while 6 (10.7 %) controls had obesity. Hypogonadism (predominantly secondary in (78.5 %)) was present in 42 (38.9 %) of the DM patients. In the controls, only 2 (3.6 %) had hypogonadism. Predictors of hypogonadism were a high HbA1c. Hypogonadism, which was predominantly secondary hypogonadism, was prevalent in the patients and was associated with HbA1c levels.

Clinicopathologic assessment of hypogonadism in men with type 2 diabetes mellitus.

Objective:To determine the prevalence of hypogonadism in men with type 2 diabetes mellitus and evaluate its clinical and pathologic correlates.Subjects and Methods:In a cross-sectional survey of 200 type 2 diabetic males aged 32–69 years, total testosterone (TT), follicle stimulating hormone, luteinizing hormone, waist circumference (WC), glycated hemoglobin, and lipids were measured. Clinical assessment of androgen deficiency was done using the androgen deficiency in aging male (ADAM) questionnaire. Overt hypogonadism was defined as a combination of positive ADAM score and TT < 8 nmol/L while possible hypogonadism was defined as positive ADAM score with TT 8–12 nmol/L.Results:Overt and possible hypogonadism occurred in 29.5% and 23% of the participants, respectively. Majority (76.3%) of the subjects who had overt hypogonadism had the hypogonadotrophic pattern. Hypogonadal subjects were significantly older (P = 0.014) and had higher mean WC (P = 0.009) than eugonadal ones. Erectile dysfunction was the most common symptom, occurring in 79.7% of overtly hypogonadal subjects. There was a significant negative correlation between WC and serum TT (r = −0.41, P = 0.001).Conclusion:There is a high frequency of symptomatic hypogonadism in men with type 2 diabetes and the frequency increases with advancing age and visceral adiposity.

Pilot Study on the Effect of Botanical Medicine (Tribulus terrestris) on Serum Testosterone Level and Erectile Function in Aging Males With Partial Androgen Deficiency (PADAM)

This study was conducted on 30 consecutive male patients presenting to Kasr-Al Ainy Andrology outpatient clinic complaining of manifestations of partial androgen deficiency in aging males (PADAM). In this study (750 mg/day) of Tribulus terrestris in 3 divided doses, each of 250 mg, as an endogenous testosterone enhancer had been tried for a duration of 3 months and the evaluation of its effect had been monitored for each patient concerning its effect on serum testosterone (total and free) and luteinizing hormone (LH), as well as its impact on erectile function, which was evaluated by the International Index of Erectile Function-5 (IIEF-5) questionnaire for those patients. Results showed a statistically significant difference in the level of testosterone (total and free) and IIEF-5, but no statistically significant difference in the level of LH before and after treatment. Also, the study showed statistically significant correlation between testosterone (total and free) and IIEF-5, but no statistically significant correlation between the level of LH and the IIEF-5 before and after treatment.

PD37-05 THE IMPACT OF TESTOSTERONE SUPPLEMENTATION THERAPY ON THE INTERNATIONAL INDEX OF ERECTILE FUNCTION: BEYOND THE LEVELS OF TESTOSTERONE

INTRODUCTION AND OBJECTIVES: To investigate the association between hypogonadal symptoms and calculated free testosterone levels in men with near normal total testosterone levels (250 e 350ng/dL). We also attempted to determine whether there exists a clear-cut discriminatory threshold of free testosterone below which hypogonadal symptoms become more prevalent. METHODS: We retrospectively reviewed the charts of 3,167 men who presented to an outpatient men’s health clinic. Of these men, 231 men had a T value between 250 e 350 ng/dL with a chief complaint of “low testosterone”. Men using testosterone or other androgenic anabolic steroids (AAS) within 6 months of the time of the survey were excluded. We also excluded men who had presented with a primary diagnosis of infertility, Kleinfelter syndrome, or secondary hypogonadism after appropriate assessment of history and endocrine evaluation with gonadotropins. We evaluated hypogonadal symptoms using the Androgen deficiency in Aging Male (ADAM) questionnaire and quantitative ADAM questionnaire. Serum levels of total testosterone, sexhormone binding globulin (SHBG) were collected on the same day that men completed their questionnaires. FT levels were calculated using the Vermeulen formula. We used locally weighted linear regression to identify threshold levels of FT below which the probability of a symptom increased above the background prevalence in the overall study population. We subsequently performed univariate (t test, chi-square) and multivariate analyses (ordinal logistic regression) to evaluate factors that predicted a low free testosterone level. RESULTS: The mean age of the 231 men was 48.4 þ 16.2 y, and the mean T level and FT levels were 292 þ 36 ng/dL, and 6.7 þ 1.26 ng/dL respectively. Significant associations between free testosterone levels and a number of androgen deficiency symptoms were seen at FT levels of 5.0 e 7.0 ng/dL, but multiple logistic regression analysis revealed confounding effects with age. Of the 10 hypogonadal symptoms, the probability of having psychological (decreased energy and sadness) and physical (decreased strength, falling asleep after dinner and deterioration of work performance) symptoms was associated with FT on a univariate analysis. However, on multivariable analysis, only younger age correlated positively with higher FT. CONCLUSIONS: Hypogonadal symptoms in men with near normal total testosterone levels can be associated with a free testosterone level. Symptom-specific free testosterone thresholds could not be defined, as age remains an important confounder.

Hypogonadal symptoms in young men are associated with a serum total testosterone threshold of 400 ng/dL.

To investigate the association between hypogonadal symptoms and serum total testosterone (TT) levels in young men (aged <40 years), in an attempt to determine whether there exists a clear-cut discriminatory threshold of TT below which hypogonadal symptoms become more prevalent. We retrospectively reviewed the charts of 352 men who presented to an outpatient Men's Health Clinic with chief complaint of 'low testosterone'. Sexual, psychological and physical symptoms were evaluated using the Androgen deficiency in Aging Male (ADAM) questionnaire. Serum levels of TT were collected on the same day that men completed their ADAM questionnaires. We subsequently performed univariate (t-test, chi-square) and multivariate analyses (ordinal logistic regression) to evaluate factors that predicted a low TT level. The probability of hypogonadal symptoms increased at a serum TT level of 400 ng/dL. A cluster of symptoms: two psychological ('decreased energy', 'sadness'), and three physical ('decreased strength and endurance', 'decreased ability to play sports', and 'deterioration in work performance') were most strongly associated with serum TT levels of <400 ng/dL. On multivariable analysis, only 'lack of energy' predicted a TT level of <400 ng/dL. Hypogonadal symptoms in men aged <40 years can be associated with a TT level of <400 ng/dL. Of the hypogonadal symptoms evaluated with the ADAM questionnaire, 'lack of energy' appears to be the most important symptom that predicts a TT level of <400 ng/dL.

Sperm Concentration Is Poorly Associated With Hypoandrogenism in Infertile Men

To evaluate the utility of routine hormone evaluation in all men presenting for infertility by understanding the relationship between sperm concentration and hypoandrogenism. We performed a retrospective cross-sectional study between September 2013 and May 2014 at a tertiary referral center in Utah. Ninety-four men presenting for infertility consecutively between the ages of 18 and 55 years were identified. Our primary outcome was rate of hypoandrogenism among infertile men defined as the baseline total serum testosterone levels <300 ng/dL or bioavailable testosterone (BAT) levels <155 ng/dL. Secondary outcomes included association of normospermia, oligozoospermia, or azoospermia with biochemical or clinical hypoandrogenism. Thirty-nine men (41%) had a total serum testosterone level of <300 ng/dL, and 41 men (43%) had a BAT level <155 ng/dL. Biochemical and symptomatic hypoandrogenism was common; 17 men (18%) had a total testosterone level <300 ng/dL and ≥ 3 positive Androgen Deficiency in Aging Male (ADAM) responses, and 18 men (19%) had a BAT level of <155 ng/dL and ≥ 3 positive ADAM responses. Sperm concentration (normospermia, oligozoospermia, and azoospermia) was not associated with biochemical hypoandrogenism (total testosterone level <300 ng/dL or BAT level <155 ng/dL), symptomatic hypoandrogenism (≥ 3 positive ADAM responses), or sexual dysfunction (Sexual Health Inventory for Men score <21). Hypoandrogenism is common among infertile men, and routine hormonal evaluation may identify hypoandrogenism in many infertile men with otherwise normal semen analysis. Sperm concentration (normospermia, oligozoospermia, and azoospermia) is not well associated with hypoandrogenism in infertile men.

Variable serum testosterone levels suggests different treatment thresholds for hypogonadal symptomatology

Hypogonadism is diagnosed by a combination of symptomatology and low serum testosterone. The current study assessed hypogonadal symptoms in men ≥40 years of age using the Androgen deficiency in Aging Male (ADAM) questionnaire.

MP48-06 HYPOGONADAL MEN TAKING CLOMIPHENE CITRATE REPORT SIMILAR SATISFACTION COMPARED TO MEN ON TESTOSTREONE REPLACEMENT THERAPY

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Medical and Non-surgical1 Apr 2014MP48-06 HYPOGONADAL MEN TAKING CLOMIPHENE CITRATE REPORT SIMILAR SATISFACTION COMPARED TO MEN ON TESTOSTREONE REPLACEMENT THERAPY Ranjith Ramasamy, Jason Scovell, Jason Kovac, James Dupree, Gavin Langille, Dolores Lamb, and Larry Lipshultz Ranjith RamasamyRanjith Ramasamy More articles by this author , Jason ScovellJason Scovell More articles by this author , Jason KovacJason Kovac More articles by this author , James DupreeJames Dupree More articles by this author , Gavin LangilleGavin Langille More articles by this author , Dolores LambDolores Lamb More articles by this author , and Larry LipshultzLarry Lipshultz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1480AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The efficacy of oral clomiphene citrate (CC) in the treatment of male hypogonadism has been reported. We compared satisfaction and treatment efficacy in men with symptomatic hypogonadism taking CC, testosterone gel (T gel), and testosterone injections (T injections). Methods Men receiving CC or T gel or T injections for symptomatic hypogonadism (total testosterone < 300 ng/dl) were asked to report satisfaction with their current treatment regimen with ADAM and qADAM scores. Serum testosterone levels were collected on the same day that men filled out the ADAM questionnaire. Treatment efficacy was evaluated using pre- and post-treatment serum testosterone, and satisfaction was assessed using androgen deficiency in aging male (ADAM) and quantitative ADAM (qADAM) questionnaire scores. Results The charts of 451 men on testosterone supplementation (51 on CC, 265 on T injections, and 135 on T gel) were reviewed. The mean serum total T levels in men on CC (525 ng/dL) was lower (p<0.01) than men taking T injections (1015 ng/dL), but similar to serum total T in men on gels (453.3 ng/dL, p=0.07). Post-treatment testosterone levels were higher in men taking CC, T injections and T gels compared to pre-treatment levels (227 ng/dL, 221 ng/dL, 211 ng/dL p<0.01) Despite differences in serum T, men on CC, T injection, and T gel reported similar satisfaction levels. Both the ADAM scores (2.37, 2.81, and 3.17) and quantitative ADAM scores (37.2, 36.8, and 35.6) for the men on different testosterone supplementation regimens were similar. Men taking CC were younger (38.5y) than men taking T injections (46.8y) or T gels (59.4, p< 0.01). Conclusions Testosterone supplementation regimens including CC, T gels and T injections are efficacious in improving serum total testosterone levels. However, men taking clomiphene citrate or testosterone gels report similar satisfaction levels compared to men taking testosterone injections despite lower serum total testosterone levels. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e529 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Ranjith Ramasamy More articles by this author Jason Scovell More articles by this author Jason Kovac More articles by this author James Dupree More articles by this author Gavin Langille More articles by this author Dolores Lamb More articles by this author Larry Lipshultz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Role of androgen in the elderly. What is LOH syndrome?

Late-onset Hypogonadism (LOH) syndrome has been established for a few years. It was formally called as "ADAM (Androgen deficiency in aging male) " or "PADAM (Partial androgen deficiency in aging male) " , and the international guideline has been developed. LOH is defined by reduced serum testosterone levels (either total testosterone or free testosterone). Considering "Men's health" , LOH is an important issue for the quality of life of elderly males.

Erectile Dysfunction

Erectile Dysfunction

Hypogonadotropic hypogonadism among a population of obese men: Prevalence, risk factors and reversibility after weight loss induced by bariatric surgery

Background and aims: Obesity in men is frequently associated with low levels of testosterone, loss of libido and/or erectile dysfunction. Our goal was to estimate the prevalence of hypogonadism among obese men and to determine its risk factors and reversibility after bariatric surgery. Methods: Seventy-five obese men were studied at baseline. Metabolic and hormonal parameters were measured, body composition was assessed by bioelectrical impedance and hypogonadism was evaluated by the ADAM (Androgen Deficiency in Aging Males) questionnaire. Twenty-one patients were re-evaluated after bariatric surgery. Results: At baseline, 39% of obese men had hypotestosteronemia, while symptoms of androgen deficiency were present in 93%. Total Testosterone (TT) was inversely related to body mass index (BMI) (. P<. 0.05), waist circumference (. P=. 0.012) and body fat mass (. P=. 0.022). Bariatric surgery was associated with an increase in TT (. P=. 0.001) and decreases in estradiol (E2) (. P=. 0.008) and in the E2/TT ratio (. P=. 0.001). Conclusions: Low testosterone levels are frequently observed among morbidly obese men and are correlated with the degree of abdominal adiposity, but not strongly with the presence of sexual dysfunction. Bariatric surgery leads to normalized TT and to decreased E2 and E2/TT ratio, suggesting a role of excessive aromatization in the hypotestosteronemia associated with obesity.