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Posted: July 08, 2008

Hormone Replacement Benefits Older Men with Low Testosterone

Older men with low testosterone improved their risk for cardiovascular disease and diabetes after receiving testosterone replacement therapy, according to two new studies.


Testosterone deficiency becomes more common with age, occurring in 18% of all 70-year-olds, said a co-author of both studies, Farid Saad, PhD, of German drug maker Bayer Schering Pharma. Low testosterone levels are linked to the metabolic syndrome -- a cluster of metabolic risk factors that increase the chances of developing heart disease, stroke, and type 2 diabetes -- and other health problems, including loss of bone and muscle mass, depression, and decreased libido.

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Saad’s research showed that restoring testosterone to normal levels in hypogonadal, or testosterone-deficient, men led to major and progressive improvements in the metabolic syndrome, which unchecked increases the risk of coronary heart disease and other diseases related to the buildup of plaque in the body.


Furthermore, men older than age 63 benefited as much as younger men, Saad and his colleagues found. Treatment lasted a year and used a slow-release, injectable form of the hormone called testosterone undecanoate that is not yet available in the United States.


The research findings of both studies were presented at the annual meeting of The Endocrine Society in San Francisco.


All 95 men in the studies, who ranged in age from 34 to 69, had the metabolic syndrome. To receive this diagnosis, patients must have three of the following five risk factors: increased waist circumference (abdominal fat), low HDL (“good”) cholesterol, high triglycerides (fats in the blood), high blood pressure, and high blood sugar.


The first study showed that testosterone treatment significantly reduced waist circumference, total cholesterol, LDL (“bad”) cholesterol, triglycerides, and body mass index, which is used as a measure of body fat. Treatment also increased “good” cholesterol. Improvements were progressive over 12 months, indicating that benefits may continue past one year, Saad said.


In the second study, the researchers divided the patient population into three groups by age: less than age 57, 57 to 63, and older than 63. They found that the oldest men had similar improvements in metabolic risk factors to the youngest men.


Additionally, the investigators looked at the degree of testosterone deficiency before treatment. However, this beginning level of testosterone deficiency did not predict the beneficial outcome, they found. Men whose sub-normal testosterone levels were not as low as the others had similar improvements in metabolic risk factors as men with the lowest levels, according to Saad.


“We conclude that if elderly men have a deficiency of testosterone, it is worthwhile to treat them with testosterone,” he said.

Researchers from The Netherlands and Germany collaborated on these studies. Study participants received treatment in a hospital clinic in Bremerhaven, Germany, which provided free care and testosterone through the German social health care system.


Bayer Schering makes a brand of testosterone undecanoate. Saad is an employee of Bayer Schering, which contributed to the study design, he said.

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