Endocrine Abstracts

Background: Hypogonadism is a clinical entity characterized by low serum testosterone (T) levels associated with several clinical signs and symptoms which can negatively affect the quality of life. T replacement therapy (TRT), restoring serum T concentrations, improves signs and symptoms related to hypogonadism. Many T formulations are presently available. The aim of the study was to assess effects of 2% gel TRT on serum T concentrations, erectile function, muscle strength and general wellbeing in men affected by normo-hypogonadotropic hypogonadism.

Materials and methods: Twenty-five patients (mean age 33±5 years) affected by mild to moderate normo-hypogonadotropic hypogonadism with different etiology (20 functional, 3 post-pituitary surgery, 1 autoimmune, 1 post-traumatic) were enrolled into the study. T 2% gel was administered at a dose ranging between 20 and 90 mg/day. Serum total T, DHT, International Index of Erectile Function-5 (IIEF-5) and the Aging Male Symptom Scale (items 1 and 10) questionnaires were evaluated before and after 3–6 months of TRT. IIEF-5 evaluates erectile function, whereas item 1 and 10 of AMSS evaluate respectively general wellbeing and muscle strenght.

Results: Normal serum testosterone levels were restored in all patients after 3–6 months of treatment. TRT determined a significant increase in serum total T (P<0.001) and DHT (P=0.008) levels. T normalization resulted in an improvement of sexual function (P<0.001), muscle strength (P=0.004) and general wellbeing (P=0.002). A direct correlation was found between the increase of total testosterone and the improvement of IIEF-5 (P=0.002), muscle strenght (P=0.012) and general wellbeing (P=0.039). No significant correlation was discovered neither between dose of T administered and improvement in IIEF-5 score (P=0.15) nor between dose of T administered and improvement of muscle strenght (P=0.093).

Conclusions: Transdermal 2% gel TRT is able to restore physiological total T levels in men affected by normo-hypogonadotropic hypogonadism improving signs and symptoms related to hypogonadism. Therefore, it can be considered an effective alternative TRT.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.