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*TESTOSTERONE
The Journal of Clinical Endocrinology & Metabolism Vol. 82, No. 6 1661-1667
Copyright © 1997 by The Endocrine Society


Reproductive Endocrinology

Testosterone Replacement in Older Hypogonadal Men: A 12-Month Randomized Controlled Trial

Rahmawati Sih, John E. Morley, Fran E. Kaiser, Horace M. Perry, III, Ping Patrick and Candie Ross

Division of Geriatric Medicine, St. Louis University Health Sciences Center (R.S., J.E.M., F.E.K., H.M.P., P.P., C.R.), St. Louis, Missouri 63104; and Geriatric Research and Education Clinical Center, St. Louis-Veterans Affairs Medical Center (R.S., J.E.M., H.M.P.), St. Louis, Missouri 63125

Address all correspondence and requests for reprints to: Rahmawati Sih, Division of Geriatric Medicine, St. Louis University Health Sciences Center, 1402 South Grand Boulevard, Room M238, St. Louis, Missouri 63104.

A decline in testicular function is recognized as a common occurrence in older men. However data are sparse regarding the effects of hypogonadism on age-associated physical and cognitive declines. This study was undertaken to examine the year-long effects of testosterone administration in this patient population.

Fifteen hypogonadal men (mean age 68 ± 6 yr) were randomly assigned to receive a placebo, and 17 hypogonadal men (mean age 65 ± 7 yr) were randomly assigned to receive testosterone. Hypogonadism was defined as a bioavailable testosterone <60 ng/dL. The men received injections of placebo or 200 mg testosterone cypionate biweekly for 12 months. The main outcomes measured included grip strength, hemoglobin, prostate-specific antigen, leptin, and memory.

Testosterone improved bilateral grip strength (P < 0.05 by ANOVA) and increased hemoglobin (P < 0.001 by ANOVA). The men assigned to testosterone had greater decreases in leptin than those assigned to the control group (mean ± SEM: -2.0 ± 0.9 ng/dL vs. 0.8 ± 0.7 ng/dL; P < 0.02). There were no significant changes in prostate-specific antigen or memory. Three subjects receiving placebo and seven subjects receiving testosterone withdrew from the study. Three of those seven withdrew because of an abnormal elevation in hematocrit.

Testosterone supplementation improved strength, increased hemoglobin, and lowered leptin levels in older hypogonadal men. Testosterone may have a role in the treatment of frailty in males with hypogonadism; however, older men receiving testosterone must be carefully monitored because of its potential risks.




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Cognitive Changes Associated With Supplementation of Testosterone or Dihydrotestosterone in Mildly Hypogonadal Men: A Preliminary Report
J Androl, July 1, 2003; 24(4): 568 - 576.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
J. E. Morley
The Need for a Men's Health Initiative
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2003; 58(7): M614 - 617.
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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
G. A. Wittert, I. M. Chapman, M. T. Haren, S. Mackintosh, P. Coates, and J. E. Morley
Oral Testosterone Supplementation Increases Muscle and Decreases Fat Mass in Healthy Elderly Males With Low-Normal Gonadal Status
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2003; 58(7): M618 - 625.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
M.-M. G. Wilson
"PREEMPTIVE STRIKE?": SARCOPENIA AND NUTRITIONAL INTERVENTION
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2003; 58(7): M672 - 673.
[Full Text] [PDF]


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Diabetes CareHome page
M. Fukui, Y. Kitagawa, N. Nakamura, M. Kadono, S. Mogami, C. Hirata, N. Ichio, K. Wada, G. Hasegawa, and T. Yoshikawa
Association Between Serum Testosterone Concentration and Carotid Atherosclerosis in Men With Type 2 Diabetes
Diabetes Care, June 1, 2003; 26(6): 1869 - 1873.
[Abstract] [Full Text] [PDF]


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J AndrolHome page
S. Bhasin, A. B. Singh, R. P. Mac, B. Carter, M. I. Lee, and G. R. Cunningham
Managing the Risks of Prostate Disease During Testosterone Replacement Therapy in Older Men: Recommendations for a Standardized Monitoring Plan
J Androl, May 1, 2003; 24(3): 299 - 311.
[Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
J. E. Morley and H. M. Perry III
Androgens and Women at the Menopause and Beyond
J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2003; 58(5): M409 - 416.
[Full Text] [PDF]


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Am. J. Physiol. Endocrinol. Metab.Home page
L. J. Woodhouse, S. Reisz-Porszasz, M. Javanbakht, T. W. Storer, M. Lee, H. Zerounian, and S. Bhasin
Development of models to predict anabolic response to testosterone administration in healthy young men
Am J Physiol Endocrinol Metab, May 1, 2003; 284(5): E1009 - E1017.
[Abstract] [Full Text] [PDF]


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Endocr. Rev.Home page
F. C. W. Wu and A. von Eckardstein
Androgens and Coronary Artery Disease
Endocr. Rev., April 1, 2003; 24(2): 183 - 217.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
T. W. Storer, L. Magliano, L. Woodhouse, M. L. Lee, C. Dzekov, J. Dzekov, R. Casaburi, and S. Bhasin
Testosterone Dose-Dependently Increases Maximal Voluntary Strength and Leg Power, but Does Not Affect Fatigability or Specific Tension
J. Clin. Endocrinol. Metab., April 1, 2003; 88(4): 1478 - 1485.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
W. A. Banks and J. E. Morley
Memories Are Made of This: Recent Advances in Understanding Cognitive Impairments and Dementia
J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2003; 58(4): M314 - 321.
[Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
S. H. Tariq MD
KNOWLEDGE ABOUT LOW TESTOSTERONE IN OLDER MEN
J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2003; 58(4): M382 - 383.
[Full Text] [PDF]


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J. Appl. Physiol.Home page
W. J. Lee, J. McClung, G. A. Hand, and J. A. Carson
Overload-induced androgen receptor expression in the aged rat hindlimb receiving nandrolone decanoate
J Appl Physiol, March 1, 2003; 94(3): 1153 - 1161.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
K. L. Herbst, B. D. Anawalt, J. K. Amory, A. M. Matsumoto, and W. J. Bremner
The Male Contraceptive Regimen of Testosterone and Levonorgestrel Significantly Increases Lean Mass in Healthy Young Men in 4 Weeks, but Attenuates a Decrease in Fat Mass Induced by Testosterone Alone
J. Clin. Endocrinol. Metab., March 1, 2003; 88(3): 1167 - 1173.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
H. T. Blumenthal
The Aging-Disease Dichotomy: True or False?
J. Gerontol. A Biol. Sci. Med. Sci., February 1, 2003; 58(2): M138 - 145.
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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
C. P. Lambert, D. H. Sullivan, and W. J. Evans
Effects of Testosterone Replacement and/or Resistance Training on Interleukin-6, Tumor Necrosis Factor Alpha, and Leptin in Elderly Men Ingesting Megestrol Acetate: A Randomized Controlled Trial
J. Gerontol. A Biol. Sci. Med. Sci., February 1, 2003; 58(2): M165 - 170.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Endocrinol. Metab.Home page
E. T. Schroeder, A. Singh, S. Bhasin, T. W. Storer, C. Azen, T. Davidson, C. Martinez, I. Sinha-Hikim, S. V. Jaque, M. Terk, et al.
Effects of an oral androgen on muscle and metabolism in older, community-dwelling men
Am J Physiol Endocrinol Metab, January 1, 2003; 284(1): E120 - E128.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
K. T. Brill, A. L. Weltman, A. Gentili, J. T. Patrie, D. A. Fryburg, J. B. Hanks, R. J. Urban, and J. D. Veldhuis
Single and Combined Effects of Growth Hormone and Testosterone Administration on Measures of Body Composition, Physical Performance, Mood, Sexual Function, Bone Turnover, and Muscle Gene Expression in Healthy Older Men
J. Clin. Endocrinol. Metab., December 1, 2002; 87(12): 5649 - 5657.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
M. Iannuzzi-Sucich, K. M. Prestwood, and A. M. Kenny
Prevalence of Sarcopenia and Predictors of Skeletal Muscle Mass in Healthy, Older Men and Women
J. Gerontol. A Biol. Sci. Med. Sci., December 1, 2002; 57(12): M772 - 777.
[Abstract] [Full Text] [PDF]


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JAMAHome page
M. R. Blackman, J. D. Sorkin, T. Munzer, M. F. Bellantoni, J. Busby-Whitehead, T. E. Stevens, J. Jayme, K. G. O'Connor, C. Christmas, J. D. Tobin, et al.
Growth Hormone and Sex Steroid Administration in Healthy Aged Women and Men: A Randomized Controlled Trial
JAMA, November 13, 2002; 288(18): 2282 - 2292.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
G. Kilciler, M. Ozata, C. Oktenli, S.Y. Sanisoglu, E. Bolu, N. Bingol, M. Kilciler, I. C. Ozdemir, and M. Kutlu
Diurnal Leptin Secretion Is Intact in Male Hypogonadotropic Hypogonadism and Is Not Influenced by Exogenous Gonadotropins
J. Clin. Endocrinol. Metab., November 1, 2002; 87(11): 5023 - 5029.
[Abstract] [Full Text] [PDF]


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J AndrolHome page
R. E. Gerstenbluth, P. N. Maniam, E. W. Corty, and A. D. Seftel
Prostate-Specific Antigen Changes in Hypogonadal Men Treated With Testosterone Replacement
J Androl, November 1, 2002; 23(6): 922 - 926.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
J. E. Morley, H. M. Perry III, and D. K. Miller
Editorial: Something About Frailty
J. Gerontol. A Biol. Sci. Med. Sci., November 1, 2002; 57(11): M698 - 704.
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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
A. Fisher and J. E. Morley
Editorial: Antiaging Medicine: The Good, the Bad, and the Ugly
J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2002; 57(10): M636 - 639.
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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
J. E. Morley
Editorial: A Fall Is a Major Event in the Life of an Older Person
J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2002; 57(8): M492 - 495.
[Full Text] [PDF]


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Am. J. Physiol. Endocrinol. Metab.Home page
T. A. Roy, M. R. Blackman, S. M. Harman, J. D. Tobin, M. Schrager, and E. J. Metter
Interrelationships of serum testosterone and free testosterone index with FFM and strength in aging men
Am J Physiol Endocrinol Metab, August 1, 2002; 283(2): E284 - E294.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
M. M. Cherrier, B. D. Anawalt, K. L. Herbst, J. K. Amory, S. Craft, A. M. Matsumoto, and W. J. Bremner
Cognitive Effects of Short-Term Manipulation of Serum Sex Steroids in Healthy Young Men
J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3090 - 3096.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
P. Y. Liu, S. M. Wishart, and D. J. Handelsman
A Double-Blind, Placebo-Controlled, Randomized Clinical Trial of Recombinant Human Chorionic Gonadotropin on Muscle Strength and Physical Function and Activity in Older Men with Partial Age-Related Androgen Deficiency
J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3125 - 3135.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
A. M. Kenny, K. M. Prestwood, C. A. Gruman, G. Fabregas, B. Biskup, and G. Mansoor
Effects of Transdermal Testosterone on Lipids and Vascular Reactivity in Older Men With Low Bioavailable Testosterone Levels
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2002; 57(7): M460 - 465.
[Abstract] [Full Text]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
J. E. Morley and J. H. Flaherty
Editorial It's Never Too Late: Health Promotion and Illness Prevention in Older Persons
J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2002; 57(6): M338 - 342.
[Full Text]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
A. M. Kenny, S. Bellantonio, C. A. Gruman, R. D. Acosta, and K. M. Prestwood
Effects of Transdermal Testosterone on Cognitive Function and Health Perception in Older Men With Low Bioavailable Testosterone Levels
J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2002; 57(5): M321 - 325.
[Abstract] [Full Text]


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Arch NeurolHome page
M. S. Okun, W. M. McDonald, and M. R. DeLong
Refractory Nonmotor Symptoms in Male Patients With Parkinson Disease Due to Testosterone Deficiency: A Common Unrecognized Comorbidity
Arch Neurol, May 1, 2002; 59(5): 807 - 811.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
C. Wang and R. S. Swerdloff
Should the Nonaromatizable Androgen Dihydrotestosterone Be Considered as an Alternative to Testosterone in the Treatment of the Andropause?
J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1462 - 1466.
[Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
A. M. Matsumoto
Andropause: Clinical Implications of the Decline in Serum Testosterone Levels With Aging in Men
J. Gerontol. A Biol. Sci. Med. Sci., February 1, 2002; 57(2): M76 - 99.
[Full Text]


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J. Clin. Endocrinol. Metab.Home page
A. B. Singh, S. Hsia, P. Alaupovic, I. Sinha-Hikim, L. Woodhouse, T. A. Buchanan, R. Shen, R. Bross, N. Berman, and S. Bhasin
The Effects of Varying Doses of T on Insulin Sensitivity, Plasma Lipids, Apolipoproteins, and C-Reactive Protein in Healthy Young Men
J. Clin. Endocrinol. Metab., January 1, 2002; 87(1): 136 - 143.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
J. E. Morley
Editorial: Drugs, Aging, and the Future
J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2002; 57(1): M2 - 6.
[Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
C. Christmas, K. G. O'Connor, S. M. Harman, J. D. Tobin, T. Munzer, M. F. Bellantoni, C. St. Clair, K. M. Pabst, J. D. Sorkin, and M. R. Blackman
Growth Hormone and Sex Steroid Effects on Bone Metabolism and Bone Mineral Density in Healthy Aged Women and Men
J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2002; 57(1): M12 - 18.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
F. L. Malphurs and J. A. Striano
Gaze Into the Long-term Care Crystal Ball: The Veterans Health Administration and Aging
J. Gerontol. A Biol. Sci. Med. Sci., November 1, 2001; 56(11): M666 - 673.
[Abstract] [Full Text] [PDF]




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