scholarly journals Prevalence of Symptomatic Androgen Deficiency in Men

2007 ◽  
Vol 92 (11) ◽  
pp. 4241-4247 ◽  
Author(s):  
Andre B. Araujo ◽  
Gretchen R. Esche ◽  
Varant Kupelian ◽  
Amy B. O’Donnell ◽  
Thomas G. Travison ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Free Testosterone ◽  
Population Based ◽  
Total Testosterone ◽  
Androgen Deficiency ◽  
Male Population ◽  
Clinical Criteria ◽  
Testosterone Levels ◽  
Low Testosterone ◽  
Osteoporosis Fracture

Abstract Context: Despite recognition that androgen deficiency in men should be defined according to biochemical and clinical criteria, most prevalence estimates are based on low testosterone levels alone. Objective: The objective of this study was to examine the association between symptoms of androgen deficiency and low total and calculated free testosterone levels and estimate the prevalence of symptomatic androgen deficiency in men. Design: This study was a population-based, observational survey. Participants: A total of 1475 Black, Hispanic, and white men, between the ages of 30–79 yr, with complete data on testosterone, SHBG, and symptoms of androgen deficiency, and who are not taking medications that impact sex steroid levels were randomly selected from the Boston Area Community Health Survey. Outcome: Outcomes were measured as symptomatic androgen deficiency, defined as low total (<300 ng/dl) and free (<5 ng/dl) testosterone plus presence of low libido, erectile dysfunction, osteoporosis or fracture, or two or more of following symptoms: sleep disturbance, depressed mood, lethargy, or diminished physical performance. Results: Mean age of the sample was 47.3 ± 12.5 yr. Approximately 24% of subjects had total testosterone less than 300 ng/dl, and 11% of subjects had free testosterone less than 5 ng/dl. Prevalence of symptoms were as follows: low libido (12%), erectile dysfunction (16%), osteoporosis/fracture (1%), and two or more of the nonspecific symptoms (20%). Low testosterone levels were associated with symptoms, but many men with low testosterone levels were asymptomatic (e.g. in men 50+ yr, 47.6%). Crude prevalence of symptomatic androgen deficiency was 5.6% (95% confidence interval: 3.6%, 8.6%), and was not significantly related to race and ethnic group. Prevalence was low in men less than 70 yr (3.1–7.0%) and increased markedly with age to 18.4% among 70 yr olds. Projection of these estimates to the year 2025 suggests that there will be as many as 6.5 million American men ages 30–79 yr with symptomatic androgen deficiency, an increase of 38% from 2000 population estimates. Conclusions: Prevalence of symptomatic androgen deficiency in men 30 and 79 yr of age is 5.6% and increases substantially with age. The aging of the U.S. male population will cause a large increase in the burden of symptomatic androgen deficiency. Future work should address the clinical significance of low testosterone levels in asymptomatic men.

scholarly journals Low Testosterone Levels Are Common and Associated with Insulin Resistance in Men with Diabetes

2008 ◽  
Vol 93 (5) ◽  
pp. 1834-1840 ◽  
Author(s):  
Mathis Grossmann ◽  
Merlin C. Thomas ◽  
Sianna Panagiotopoulos ◽  
Ken Sharpe ◽  
Richard J. MacIsaac ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Free Testosterone ◽  
Total Testosterone ◽  
Testosterone Deficiency ◽  
Testosterone Levels ◽  
Low Testosterone

Abstract Context: Low testosterone levels are common in men with type 2 diabetes and may be associated with insulin resistance. Objective: We investigated prevalence of testosterone deficiency and the relationship between testosterone and insulin resistance in a large cohort of men with type 2 and type 1 diabetes. Design: The study was a cross-sectional survey of 580 men with type 2 diabetes and 69 men with type 1 diabetes. A subgroup of 262 men with type 2 diabetes was then reassessed after a median of 6 months. Results: Forty-three percent of men with type 2 diabetes had a reduced total testosterone, and 57% had a reduced calculated free testosterone. Only 7% of men with type 1 diabetes had low total testosterone. By contrast, 20.3% of men with type 1 diabetes had low calculated free testosterone, similar to that observed in type 2 diabetes (age-body mass index adjusted odds ratio = 1.4; 95% confidence interval = 0.7–2.9). Low testosterone levels were independently associated with insulin resistance in men with type 1 diabetes as well as type 2 diabetes. Serial measurements also revealed an inverse relationship between changes in testosterone levels and insulin resistance. Conclusions: Testosterone deficiency is common in men with diabetes, regardless of the type. Testosterone levels are partly influenced by insulin resistance, which may represent an important avenue for intervention, whereas the utility of testosterone replacement remains to be established in prospective trials.

scholarly journals Prevalence and Incidence of Androgen Deficiency in Middle-Aged and Older Men: Estimates from the Massachusetts Male Aging Study

2004 ◽  
Vol 89 (12) ◽  
pp. 5920-5926 ◽  
Author(s):  
Andre B. Araujo ◽  
Amy B. O’Donnell ◽  
Donald J. Brambilla ◽  
William B. Simpson ◽  
Christopher Longcope ◽  
...  
Keyword(s):  
Free Testosterone ◽  
Older Men ◽  
Population Based ◽  
Incidence Rates ◽  
Androgen Deficiency ◽  
Middle Aged ◽  
Male Population ◽  
Incidence Data ◽  
Aging Study

Abstract Little is known about the descriptive epidemiology of androgen deficiency. In this study, we sought to address this issue by providing estimates of the crude and age-specific prevalence and incidence rates of androgen deficiency in a randomly sampled population-based cohort of middle-aged and older men. Data on androgen deficiency (defined using both signs/symptoms plus total and calculated free testosterone) were available for n = 1691 (baseline) and n = 1087 (follow-up) men from the Massachusetts Male Aging Study. Crude and age-specific prevalence and incidence rates were calculated. Based on these estimates, projections for the number of cases of androgen deficiency in the 40- to 69-yr-old U.S. male population were computed. Estimates of the crude prevalence of androgen deficiency at baseline and follow-up were 6.0 and 12.3%, respectively. Prevalence increased significantly with age. From baseline age-specific prevalence data, it is estimated that there are approximately 2.4 million 40- to 69-yr-old U.S. males with androgen deficiency. The crude incidence rate of androgen deficiency was 12.3 per 1,000 person-years, and the rate increased significantly (P < 0.0001) with age. Based on these incidence data, we can expect approximately 481,000 new cases of androgen deficiency per year in U.S. men 40–69 yr old.

Metabolic Syndrome in Men with Low Testosterone Levels: Relationship with Cardiovascular Risk Factors and Comorbidities and with Erectile Dysfunction

2013 ◽  
Vol 10 (10) ◽  
pp. 2529-2538 ◽  
Author(s):  
Eduardo García‐Cruz ◽  
Asier Leibar‐Tamayo ◽  
Javier Romero ◽  
Marta Piqueras ◽  
Pilar Luque ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Erectile Dysfunction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Testosterone Levels ◽  
Low Testosterone

scholarly journals Low testosterone is associated with disability in men with multiple sclerosis

2014 ◽  
Vol 20 (12) ◽  
pp. 1584-1592 ◽  
Author(s):  
R Bove ◽  
A Musallam ◽  
BC Healy ◽  
K Raghavan ◽  
BI Glanz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Hypogonadotropic Hypogonadism ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Testosterone Levels ◽  
Vitamin D Levels ◽  
Relapsing Remitting ◽  
25 Hydroxy Vitamin D ◽  
Male Patients ◽  
Low Testosterone

Background: Gonadal steroids may modulate disease course in multiple sclerosis (MS). Objective: To assess the prevalence and clinical associations of hypogonadism in men with MS. Methods: Male patients, aged 18–65 years, with relapsing–remitting MS (RRMS) or clinically-isolated syndrome (CIS) and their first symptom < 10 years prior were selected from a longitudinal clinical study. We measured their hormones in stored morning blood samples, and collected their Expanded Disability Status Scale (EDSS) scores every 6 months and their Symbol Digit Modalities Test (SDMT) results annually. Results: Our analysis included 96 men with a mean age of 40 years, EDSS of 1.1 and disease duration of 4.6 years. Of these men, 39% were hypogonadal (total testosterone < 288 ng/dL); none showed compensatory elevations in luteinizing hormone. Their low testosterone levels and testosterone:estradiol ratios were negatively correlated with body mass index (BMI) and leptin, and showed no correlation with 25-hydroxy-vitamin D levels. In our primary cross-sectional analyses, there was a negative age-adjusted correlation between total testosterone and EDSS ( p = 0.044). In the age-adjusted longitudinal analyses, higher baseline testosterone levels were associated with less decline in SDMT ( p = 0.012). Conclusions: Men with MS may experience hypogonadotropic hypogonadism. Low testosterone levels may be associated with worse clinical outcomes. A potential neuroprotective role for testosterone warrants further investigation.

Correction of Androgen Deficiency in Men with Type 2 Diabetes

2021 ◽  
Vol 16 ◽  
Author(s):  
Volodymyr Pankiv ◽  
Tetyana Yuzvenko ◽  
Nazarii Kobyliak ◽  
Ivan Pankiv
Keyword(s):  
Type 2 Diabetes ◽  
Replacement Therapy ◽  
Testosterone Replacement ◽  
Control Group ◽  
Total Testosterone ◽  
Testosterone Replacement Therapy ◽  
Androgen Deficiency ◽  
Testosterone Undecanoate ◽  
Testosterone Levels

Background: In men with low levels of testosterone in the blood, it is believed that the symptoms can be regarded as an association between testosterone deficiency syndrome and related comorbidities. Aim: to investigate the effectiveness of testosterone therapy in patients with type 2 diabetes (T2D) and androgen deficiency. Materials and methods: Testosterone replacement therapy was carried out in 26 men with T2D and clinically or laboratory-confirmed androgen deficiency. The age of the subjects ranged from 35 to 69 years old. Laboratory studies included determinations of the concentration of the hormones estradiol, luteinizing hormone (LH), and prostate-specific antigen (PSA). The observation period was 9 months. Results: The average level of total blood testosterone in the subjects before treatment was 9.4 mol/l and was likely lower than that of the control group (19.3 ± 1.6 nmol/l). The levels of total testosterone in the subjects ranged from 3.9 nmol/l to 10.7 nmol/l, and hormone levels measuring less than 8.0 nmol/l were observed in only 11 patients. After a course of testosterone replacement therapy, a stabilization in total testosterone levels at the level of reference values (as compared to the start of treatment) was observed in the blood of men with T2D after 9 months of observation and the administration of the fourth injection (16.83 ± 0.75 nmol/l). Conclusion: The use of long-acting injectable testosterone undecanoate leads to normalization of total testosterone levels in the blood of men with T2D and androgen deficiency, and LH levels in these patients are unlikely to change.

scholarly journals The importance of SHBG and calculated free testosterone for the diagnosis of symptomatic hypogonadism in HIV-infected men: a single-centre real-life experience

Infection ◽  
2020 ◽  
Author(s):  
Letizia Chiara Pezzaioli ◽  
Eugenia Quiros-Roldan ◽  
Simone Paghera ◽  
Teresa Porcelli ◽  
Filippo Maffezzoni ◽  
...  
Keyword(s):  
Life Experience ◽  
Real Life ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Sexual Symptoms ◽  
Low Testosterone ◽  
Gonadal Status ◽  
Spearman’S Correlation

Abstract Purpose The prevalence of low testosterone and symptoms of hypogonadism in HIV-infected men is still debated. We aimed to estimate the prevalence and type of hypogonadism in HIV-infected males complaining about sexual symptoms, and to evaluate the role of calculated free testosterone (cFT) vs total testosterone (TT) for diagnosis. Furthermore, we evaluated relationship between sex hormone-binding globulin (SHBG), gonadal status and clinical and virologic parameters. Methods We retrospectively evaluated 169 HIV-infected men with sexual symptoms, with TT available. Among them, we selected 94 patients with TT, SHBG, cFT, and luteinizing hormone (LH) available, and classified hypogonadism into overt (low TT and/or low cFT) and compensated (high LH, normal TT and cFT). Comparison was performed by non-parametric Kruskal–Wallis test and Spearman’s correlation was calculated to verify the possible associations. Results Overt and compensated hypogonadism were found in 20.2% and 13.8% of patients, respectively. With reliance on TT alone, only 10.6% of patients would have met diagnosis. SHBG values were elevated in one third of patients, and higher in men with compensated hypogonadism. Significant positive correlation was found between SHBG and HIV infection duration, TT and LH. Conclusion Only a complete hormonal profile can properly diagnose and classify hypogonadism in HIV-infected men complaining about sexual symptoms. TT alone reliance may lead to half of diagnoses missing, while lack of gonadotropin prevents the identification of compensated hypogonadism. This largely comes from high SHBG, which seems to play a central role in the pathogenesis of hypogonadism in this population.

scholarly journals The analog free testosterone assay: are the results in men clinically useful?

1998 ◽  
Vol 44 (10) ◽  
pp. 2178-2182 ◽  
Author(s):  
Stephen J Winters ◽  
David E Kelley ◽  
Bret Goodpaster
Keyword(s):  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Serum Concentrations ◽  
Testosterone Concentration ◽  
Low Testosterone ◽  
Relationship Of ◽  
The Relationship ◽  
Constant Percentage

Abstract Men with low testosterone concentrations are usually hypogonadal. However, because variations in the testosterone transport protein, sex hormone-binding globulin (SHBG), directly influence the total testosterone concentration, confirmation of a low testosterone with a measurement of free testosterone or “bioavailable” testosterone (BAT) is recommended. In the present study, we examined the relationship of SHBG with free testosterone (Coat-A-Count assay, Diagnostic Products) and with BAT in men (n = 29) and women (n = 28) who participated in a study of the metabolic determinants of body composition. As expected, total testosterone was strongly positively correlated with SHBG among men (r = 0.68; P &lt;0.01). Although the BAT was independent of SHBG in men (r = 0.02), SHBG was an important predictor of free testosterone (r = 0. 62; P &lt;0.01). In contrast, in women serum concentrations of total testosterone (r = −0.26; P = 0.17), free testosterone (r = −0.30; P = 0.17), and BAT (r = −0.46; P = 0.013) all tended to be lower with increasing SHBG. Free testosterone was nearly perfectly positively correlated with total testosterone (r = 0.97) in men, among whom free testosterone represented a relatively constant percentage of the total testosterone (0.5–0.65%), and the percentage of free testosterone was unrelated to SHBG. Thus the Coat-A-Count free testosterone concentration in men, like the total testosterone concentration, is determined in part by plasma SHBG. Accordingly, androgen deficiency may be misclassified with this assay in men with low SHBG. Moreover, the previous findings of reduced free testosterone concentrations with hypertension or hyperinsulinemia or as a risk factor for developing type 2 diabetes, conditions in which SHBG is reduced, may have been methodology-related.

scholarly journals Hypoactive sexual desire in transsexual women: prevalence and association with testosterone levels

2008 ◽  
Vol 158 (3) ◽  
pp. 393-399 ◽  
Author(s):  
Els Elaut ◽  
Griet De Cuypere ◽  
Petra De Sutter ◽  
Luk Gijs ◽  
Michael Van Trotsenburg ◽  
...  
Keyword(s):  
Sexual Desire ◽  
Free Testosterone ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Oestrogen Treatment ◽  
Testosterone Levels

ObjectiveAn unknown proportion of transsexual women (defined as post-operative male-to-female transsexuals on oestrogen replacement) experience hypoactive sexual desire disorder (HSDD). It has been suggested that the absence of ovarian androgen production together with oestrogen treatment-related increase in sex hormone-binding globulin (SHBG) levels could be leading to HSDD, due to low levels of biologically available testosterone. This study wishes to document the HSDD prevalence among transsexual women and the possible association to androgen levels.DesignCross-sectional study.MethodsTranssexual women (n=62) and a control group of ovulating women (n=30) participated in this study. Questionnaires measuring sexual desire (sexual desire inventory) and relationship and sexual satisfaction (Maudsley Marital Questionnaire) were completed. Serum levels of total testosterone, LH and SHBG were measured in blood samples obtained at random in transsexual women and in the early follicular phase in ovulating women.ResultsThe transsexual group had lower levels of total and calculated free testosterone (both P<0.001) than the ovulating women. HSDD was reported in 34% of the transsexual and 23% of the ovulating women (P=0.30). Both groups reported similar levels of sexual desire (P=0.97). For transsexual women, no significant correlation was found between sexual desire and total (P=0.64) or free testosterone (P=0.82). In ovulating women, these correlations were significant (P=0.006, resp. P=0.003).ConclusionsHSDD is reported in one-third of transsexual women. This prevalence is not substantially different from controls, despite markedly lower (free) testosterone levels, which argues against a major role of testosterone in this specific group.

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