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Testosterone deficiency & the safety of replacement therapy

Published: 21st Jun, 2022

Context

A new study found that the testosterone treatment increases the risk of cardiovascular events such as arrhythmia, heart attack, and stroke, in the short to medium terms.

About

Hypogonadism:

  • It is a condition caused by the deficiency of the male sex hormone, testosterone.
  • Types - There are two types of hypogonadism: primary and central.
    • Primary hypogonadism means that you don’t have enough sex hormones in your body due to a problem in your gonads.
  • Your gonads are still receiving the message to produce hormones from your brain, but they aren’t able to produce them.
    • In central (secondary) hypogonadism, the problem lies in your brain.
  • Your hypothalamus and pituitary gland, which control your gonads, aren’t working properly.
  • Symptoms - Sexual dysfunction, weakening of bones and muscles, and reduced quality of life.
  • Risk factors include ageing (as testosterone levels decline with age), obesity and diabetes.
  • Worldwide, 2% of men aged over 40 are affected, and this is growing as the population gets older.

Testosterone replacement therapy:

  • Testosterone replacement therapy is the standard treatment for hypogonadism, which can cause sexual dysfunction, weakening of bones and muscles, and reduced quality of life.
  • Prescribing of testosterone for hypogonadism is increasing globally, but conflicting messages about its safety may have led to many patients not receiving the treatment.
  • Impacts - Testosterone treatment significantly reduced serum total cholesterol, HDL, and triglycerides.
  • However, there were no significant differences in LDL, blood pressure, glycaemic parameters, diabetes incidence, and prostate adverse outcomes.

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