Endocrine Abstracts

Background

This study was designed to monitor the clinical effectiveness of transdermal replacement. Psychological well-being was assessed by questionnaire at 3, 6 and 12

Method

We recruited 97 men requiring testosterone replacement therapy for primary (21%) or secondary (79%) hypogonadism. All had a physical examination, biochemical and haematological blood sampling (Meston et al 2004) and psychological assessment questionnaire at baseline 3, 6 and 12 months of treatment.

Results

Psychological data presented was measured by visual analogue scale from 0 (poor) to 10 (excellent). Baseline concentration score at 5.9 (geometric mean; n=96) increased at 3 months to 6.9 (n=68) and 7 (n=38) at 6 months. Memory ability improved from 5.7 (n=95) to 6.4 (n=68) then to 6.6 (n=38). Energy level started at 4.5 (n=95) rising to 6.3 (n=68) and levelled at a mean of 6 (n=38) at 6 months. Well being increased from 6.1 (n=96) to 7.2 (n=68) and 7.4 (n=38) at 6 months. Sexual desire elevated from 3.9 (n=96) to 5.8 (n=68) at 3 months and 6 (n=38) at the 6-month evaluation. Sexual activity started at the lowest mean of 2.9 (n=96), then increased to 10 (n=68) at 3 months and decreased at 6 months to 4.9 (n=38).

Six patients (6.7%) increased to 75mg daily from the standard 50mg starting dose, based on low pre-dose testosterone, and one (1.1%) increased to 100mg before reaching hormonal levels within reference interval. Six patients (6.7%) reduced to 25mg daily because of either raised prostate or haemoglobin indices.

Conclusion

Testosterone replacement in a hydroalcholic gel provides effective hormonal replacement with high patient acceptability an improvement in general well being and low incidence of complications. One sachet (50mg) provided adequate testosterone replacement in 86% of subjects.