Endocrine Abstracts

Introduction: Testogel is now established treatment for male hypogonadism. The aim of TRT is to resolve hypogonadal symptoms and achieve physiological levels of testosterone.

Objective: To determine the efficacy of Testogel 50 mg/day, in achieving symptomatic benefit and physiological testosterone level in 100 male patients.

Method: Retrospective review of 100 case notes from the andrology clinic. Men included were between 16 and 80 years. A database was established recording their demographic data, treatment regimes, serum testosterone [TT], calculated bioavailable testosterone, SHBG, FSH, LH, PSA, Hb, and Hct were at baseline, 3, 6, 9, and 12 months after treatment with Testogel.

Results: 59% were aged 51–70 years. 39% had secondary, 36% primary and 25% mixed hypogonadism. 45% were started on Testogel de novo, and 55% were switched over from other treatments.

In de novo patients mean TT was 16.3 nmol/l, 18.3 nmol/l, then 19.7 nmol/l at 3, 6, and 12 months respectively. For those switched to Testogel, mean TT was 13.1 nmol/l, 13.0 nmol/l, and 15.6 nmol/l for the same intervals. Collectively the mean TT levels demonstrated as expected a statistically significant rise with P=0.038 using a paired t test. On Testogel serum TT failed to rise to physiological levels [11–30 nmol/l] in 19% at 3 months, 17% at 6 months and in 13% at 12 months despite dose adjustment. Supraphysiological levels [>30 nmol/l] of testosterone were reached in 4% after 3 months treatment 5% after 6 months and 6% after 12 months. During this period of treatment 7% changed to other modes of testosterone therapy. 6% are unhappy on testogel and planning to change. One patient was diagnosed with prostate cancer and his treatment stopped.

Discussion: Testogel achieves physiological TT in majority of patients on TRT and was associated with symptomatic improvement. Not all patients achieved consistent levels of testosterone within the physiological range, which potentially could be due to compliance, area of application, or difference in dermal absorption.