Stimulating hormone therapy in the treatment of age related hypogonadism
1: Scientific&Practical Centre of Preventive&Clinical Medicine, Ukraine
Objectives: Androgen replacement therapy has proved to be standard approach for aging male testosterone deficiency. But it has a number of disadvantages and side effects such as infertility, huge variation in testosterone levels, discomfort because of administration form (gel: skin reaction; intra-muscular injections: pain), by-passing natural endogenous source of androgens (Leydig cells) and risk of gynecomastia . In this study we report our experience using stimulating hormone therapy (human chorionic gonadotropin) to treat age related hypogonadism.
Materials and Methods: As of October 2015 75 patients with age related hypogonadism (diagnosis criteria: low total testosterone 8.0 -12,0 nmol/l, symptoms of low testosterone (AMS >30) and documented erectile dysfunction (ED) by IIEF≤15) were included in a study to investigate the effect of hHG therapy (1500 IU) by subcutaneous injection. Treatment was administered 2 times/week during 3 months. Mean age was 55,4+2,3 (49-62 years). Prostate volume, prostate-specific antigen (PSA), hormonal level (T, LH), biochemical lipid spectrum, aging male symptoms (AMS), International Index of erectile function – erectile function (IIEF-EF) and International Prostate Symptoms Scores (IPSS) were measured over the study period and percentage of change from baseline were calculated. Treatment was began after determination of testicular reserve function, which consisted in 3 hCG injections(1500 IU ) and serum T control. The result was considered as positive in case of the 2 fold T serum level increases.
Results: After interruption, hCG therapy resulted in improvements AMS (decreased from 37,3+ 3,1 till 28+2,5), IIEF-EF (increased from 13+ 1,9 till 20+2,2) and T (increased from 8,3+ 2,1 nmol/l till 14, 5+ 2,4 nmol/l ), cholesterol level (decreased from 5,3 + 1,5 ммоль/л till 4, 5+1,2 ммоль/л) while PSA, LG, IPSS and prostate volume did not essentially change.
Conclusions: Long-term treatment with hCG therapy results in significant reduction of all parameters of age related hypogonadism. This hormonal alternative, which proved to be effective and safe in our preliminary series, may be offered to patients with age related hypogonadism.
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