Endocrine Abstracts

Background: Various forms of testosterone replacement therapy has been used in replacement therapy for transmen and men with hypogonadism. However, efficacy and safety of testosterone implant has not been studied yet.

Methods: 11 patietns (five transmen and six men with hypogonadism) had 800–1000 mg of testosterone implant inserted subcutaneously in the anterior abdominal wall. All subjects had previously been on other forms of testosterone replacement. Patients were interviewed for symptoms of low sex hormones, their satisfaction on treatment and presence of complications before their first implant and in a subsequent visit. Blood tests were done before the 1st implant was inserted and on a subsequent visit before the implant was inserted. They were also asked to grade their energy level, general drive and libido from a scale of 0–10. Pre-and post-implant data were analysed by using paired t-tests.

Findings: In a scale of 0–10, patient’s energy level (4.7±2.2 vs 7.1±2.0, P=0.026), general drive (5.1±2.1 vs 7.6±1.2, P=0.003) and libido (3.0±2.6 vs 7.2±2.4, P=0.002) improve post-implant in comparison with pre-implant symptoms. No significant change in liver enzymes or lipid profile were noted. Haemoglobin (15.1±1.6 vs. 15.6±1.8 g/dl, P=0.15) and haematocrit (0.45±0.05 vs. 0.47±0.05, P=0.07) were not significantly different pre- and post- implant. Serum testosterone level did not change significantly pre- and post-implant (9.3±9.0 vs. 10.7±3.9 mmol/l, P=0.64). Compared to previous testosterone replacement in other forms, 73% of the patients said implant therapy was better whereas 27% said it was the same. There was no complications in all 11 patients studied.

Conclusion: Testosterone implant improves symptoms of hypogonadism. None of the subjects had any complications or side effects such as polycythaemia. Therefore, testosterone implant treatment is a safe and effective therapy for symptoms improvement in transmen and men with hypogonadism. It may be considered as a form of replacement in selected patients who do not respond to other form of testosterone replacement.